Provider Demographics
NPI:1396851143
Name:ZAYAS RIVERA, JALIXA E
Entity Type:Individual
Prefix:
First Name:JALIXA
Middle Name:E
Last Name:ZAYAS RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 71 BOX 3758
Mailing Address - Street 2:
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00179
Mailing Address - Country:US
Mailing Address - Phone:787-318-0933
Mailing Address - Fax:
Practice Address - Street 1:BO. ACHIOTE
Practice Address - Street 2:SECT. DESVIO
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719
Practice Address - Country:US
Practice Address - Phone:787-869-1290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1752183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician