Provider Demographics
NPI:1275913899
Name:RIVERA BERRIOS, RAUL JOSE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:JOSE
Last Name:RIVERA BERRIOS
Suffix:
Gender:M
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:PO BOX 1818
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-1818
Mailing Address - Country:US
Mailing Address - Phone:787-764-1194
Mailing Address - Fax:787-756-8807
Practice Address - Street 1:370 AVE DOMENECH
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3720
Practice Address - Country:US
Practice Address - Phone:787-764-1194
Practice Address - Fax:787-756-8807
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5393183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist