Provider Demographics
NPI:1174276430
Name:GONZALEZ RIVERA, CRISTINA IRAIS (PHARMD)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:IRAIS
Last Name:GONZALEZ 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:URB SAN CARLOS A9
Mailing Address - Street 2:CIRCULO SAN JOSE
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603
Mailing Address - Country:US
Mailing Address - Phone:787-505-9479
Mailing Address - Fax:
Practice Address - Street 1:CARR. 402 KM 1.8
Practice Address - Street 2:BO. MARIAS, ZONA INDUSTRIAL
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-229-1515
Practice Address - Fax:787-229-1516
Is Sole Proprietor?:No
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR007010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist