Provider Demographics
NPI:1043772130
Name:ORTIZ RIVERA, JOMARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOMARIE
Middle Name:
Last Name:ORTIZ RIVERA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A5 CALLE 1
Mailing Address - Street 2:VILLA CRISTINA
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769
Mailing Address - Country:US
Mailing Address - Phone:787-478-0215
Mailing Address - Fax:787-825-2290
Practice Address - Street 1:CARR 153 KM 6.9 INT PLAZA OASIS
Practice Address - Street 2:BO FELICIA SECTOR PASO SECO
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757
Practice Address - Country:US
Practice Address - Phone:787-845-6272
Practice Address - Fax:787-825-2290
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR006639183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist