Provider Demographics
NPI:1073630331
Name:RIVERA, AMERICA (PHARMASIST)
Entity Type:Individual
Prefix:MISS
First Name:AMERICA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:PHARMASIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 36 BOX 8124
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9561
Mailing Address - Country:US
Mailing Address - Phone:787-781-3352
Mailing Address - Fax:787-782-3081
Practice Address - Street 1:RR 36 BOX 8124
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-9561
Practice Address - Country:US
Practice Address - Phone:787-781-3352
Practice Address - Fax:787-782-3081
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2790183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist