Provider Demographics
NPI:1407256779
Name:RODRIGUEZ-RIVERA, CAROLYN (PHARM D)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:RODRIGUEZ-RIVERA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ALTURAS DE MONTECASINO STREET CERRO 7
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00953
Mailing Address - Country:UM
Mailing Address - Phone:787-758-2500
Mailing Address - Fax:787-622-2429
Practice Address - Street 1:PONCE DE LEON AVE MCS PLAZA SUITE 1500
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00902 4200
Practice Address - Country:UM
Practice Address - Phone:787-758-2500
Practice Address - Fax:787-622-2429
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-24
Last Update Date:2014-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4418183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist