Provider Demographics
NPI:1043342850
Name:RAMON LUIS DIAZ- RIVERE
Entity Type:Organization
Organization Name:RAMON LUIS DIAZ- RIVERE
Other - Org Name:FARMACIA KRISTEL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:DIAZ-RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-871-4812
Mailing Address - Street 1:PO BOX 1080
Mailing Address - Street 2:
Mailing Address - City:CIALES
Mailing Address - State:PR
Mailing Address - Zip Code:00638-1080
Mailing Address - Country:US
Mailing Address - Phone:787-871-4812
Mailing Address - Fax:787-871-1323
Practice Address - Street 1:15 CALLE PALMER
Practice Address - Street 2:
Practice Address - City:CIALES
Practice Address - State:PR
Practice Address - Zip Code:00638-3235
Practice Address - Country:US
Practice Address - Phone:787-871-4812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3657183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty