Provider Demographics
NPI:1811392582
Name:ESTEVEZ-RIVERA, PAMELA ELENA (PA-C)
Entity type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:ELENA
Last Name:ESTEVEZ-RIVERA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 SW 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-2512
Mailing Address - Country:US
Mailing Address - Phone:646-290-4238
Mailing Address - Fax:
Practice Address - Street 1:805 SW 4TH AVE
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-2512
Practice Address - Country:US
Practice Address - Phone:646-290-4238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPA9117020363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL123064500Medicaid