Provider Demographics
NPI:1730601568
Name:RIVERA ACOSTA, NELKI BRUNILDA (MD)
Entity type:Individual
Prefix:
First Name:NELKI
Middle Name:BRUNILDA
Last Name:RIVERA ACOSTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 CALLE MANUEL M SAMAS
Mailing Address - Street 2:TRASTALLERES
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-5808
Mailing Address - Country:US
Mailing Address - Phone:787-673-4406
Mailing Address - Fax:
Practice Address - Street 1:CARR #111 KM 1.9 AVE LOS PATRIOTAS
Practice Address - Street 2:
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669
Practice Address - Country:US
Practice Address - Phone:787-897-2727
Practice Address - Fax:787-897-2725
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21635207Q00000X
FLME146553207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine