Basic Information
Provider Information
NPI: 1780858555
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RIVERA-ORRACA
FirstName: ZILKIA
MiddleName: MARA
NamePrefix: DR.
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: UNIVERSITY PEDIATRIC HOSPITAL
Address2: CALL BOX 191079
City: SAN JUAN
State: PR
PostalCode: 009191079
CountryCode: US
TelephoneNumber: 7877773535
FaxNumber:  
Practice Location
Address1: HOSPITAL PEDIATICO UNIVERSITARIO
Address2:  
City: SAN JUAN
State: PR
PostalCode: 009191079
CountryCode: US
TelephoneNumber: 7877773535
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/14/2008
LastUpdateDate: 04/14/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700X2289PRY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


Home