Individual provider Active NPI

Glorialys Rivera Otero

  • Student in an Organized Health Care Education/Training Program
  • San Juan, PR
National Provider Identifier
1043092471
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
46141 Issued in FL
Practice address
997 Calle San Roberto
San Juan, PR 00926-2759
Phone
(787) 773-6501
NPI assigned
Oct 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X 46141 FL Primary

Addresses

Primary practice location

997 Calle San Roberto
San Juan, PR 00926-2759

Mailing address

PO Box 1115
Barranquitas, PR 00794-1115
Phone (787) 387-2757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
46141FLMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1697673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1043092471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1115",
            "city": "BARRANQUITAS",
            "state": "PR",
            "postal_code": "007941115",
            "telephone_number": "787-387-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 CALLE SAN ROBERTO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009262759",
            "telephone_number": "787-773-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA OTERO",
        "first_name": "GLORIALYS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-19",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "46141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.