Provider Demographics
NPI:1174238406
Name:RIVERA MARTINEZ, DENIEL OSCAR I (TERAPISTA FISICO)
Entity type:Individual
Prefix:MR
First Name:DENIEL
Middle Name:OSCAR
Last Name:RIVERA MARTINEZ
Suffix:I
Gender:M
Credentials:TERAPISTA FISICO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:HC 73 BOX 5998
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-9596
Mailing Address - Country:US
Mailing Address - Phone:787-689-7803
Mailing Address - Fax:
Practice Address - Street 1:400 AVE INGENIERO NANUEL DOMENECH 402
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-0073
Practice Address - Country:US
Practice Address - Phone:787-689-7803
Practice Address - Fax:844-865-3827
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-20
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004629225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist