Provider Demographics
NPI:1407954225
Name:RIVERA VAZQUEZ, LEIMIR Y (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:LEIMIR
Middle Name:Y
Last Name:RIVERA VAZQUEZ
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:HC 4 BOX 49900
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-9483
Mailing Address - Country:US
Mailing Address - Phone:787-898-8089
Mailing Address - Fax:787-898-6239
Practice Address - Street 1:CARR. 490 KM. 3.2 BO. CAMPO ALEGRE SECTOR PAJUIL
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-820-1972
Practice Address - Fax:787-898-6239
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5175183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist