Provider Demographics
NPI:1538267794
Name:RIVERA-MEJIAS, HILDA ANGELICA (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:HILDA
Middle Name:ANGELICA
Last Name:RIVERA-MEJIAS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MRS
Other - First Name:HILDA
Other - Middle Name:ANGELICA
Other - Last Name:RIVERA-MEJIAS DE DE LEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:10622 STRADFORD ROW
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-2041
Mailing Address - Country:US
Mailing Address - Phone:407-970-0907
Mailing Address - Fax:407-260-5411
Practice Address - Street 1:10622 STRADFORD ROW
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-2041
Practice Address - Country:US
Practice Address - Phone:407-970-0907
Practice Address - Fax:407-260-5411
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 37462251N0400X, 2251P0200X, 2251N0400X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000000030871OtherCMS KIDS
FL882116096OtherMED WAIVER
FL882116000Medicaid