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Individual

WANDA I RIVERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
59 AVE ESMERALDA, URB PONCE DE LEON, GUAYNABO, PR 00969-4429
(787) 790-3848
Mailing address
59 AVE ESMERALDA, URB PONCE DE LEON, GUAYNABO, PR 00969-4429
(787) 790-3848

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
522
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100944
OPTOMETRY
PR
01
215953
OPTOMETRY
PR
01
50553
OPTOMETRY
PR
01
58260
OPTOMETRY
PR
Enumeration date
02/27/2007
Last updated
07/09/2007
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