Provider Demographics
NPI:1013899822
Name:BARBOSA RIVERA, FABIAN OBED (MSW)
Entity type:Individual
Prefix:
First Name:FABIAN
Middle Name:OBED
Last Name:BARBOSA RIVERA
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 38 BOX 7057
Mailing Address - Street 2:
Mailing Address - City:GUANICA
Mailing Address - State:PR
Mailing Address - Zip Code:00653-8817
Mailing Address - Country:US
Mailing Address - Phone:939-278-7879
Mailing Address - Fax:
Practice Address - Street 1:URB ALTURAS DE SAN JOSE HH 14
Practice Address - Street 2:ST 21
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637
Practice Address - Country:US
Practice Address - Phone:939-278-7879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-23
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR172301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty