Provider Demographics
NPI:1114206448
Name:RIOS, JUAN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:
Last Name:RIOS
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:463 CAMINO DE LA VEGA
Mailing Address - Street 2:SABANERA DORADO
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-3639
Mailing Address - Country:US
Mailing Address - Phone:787-543-4543
Mailing Address - Fax:787-796-1492
Practice Address - Street 1:35 AVE LOS DOMINICOS
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-3400
Practice Address - Country:US
Practice Address - Phone:787-795-2022
Practice Address - Fax:787-795-2052
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2642183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist