Provider Demographics
NPI:1437771581
Name:RODRIGUEZ-RIVERA, ANGEL RAFAEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:RAFAEL
Last Name:RODRIGUEZ-RIVERA
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:AK-26 MONTERREY STREET
Mailing Address - Street 2:VENUS GARDENS NORTH
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-231-9978
Mailing Address - Fax:
Practice Address - Street 1:CARR #14 KM 12.0
Practice Address - Street 2:BARRIO RINCON, SECTOR LOMAS
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-0073
Practice Address - Country:US
Practice Address - Phone:787-535-1530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6630183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist