Provider Demographics
NPI:1578664736
Name:RIVERA-TORRES, CARMEN M (LPN)
Entity type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:M
Last Name:RIVERA-TORRES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC-01 BOX 3397
Mailing Address - Street 2:
Mailing Address - City:VILLALBA
Mailing Address - State:PR
Mailing Address - Zip Code:00766-9702
Mailing Address - Country:US
Mailing Address - Phone:787-648-5650
Mailing Address - Fax:
Practice Address - Street 1:PASEO DEL VETERANO 1010
Practice Address - Street 2:VA PONCE OUTPATIENT CLINIC
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2001
Practice Address - Country:US
Practice Address - Phone:787-812-3030
Practice Address - Fax:787-651-4321
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR019431164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse