Provider Demographics
NPI:1467075333
Name:PEREZ RIVERA, ADRIANA G (PHARMD)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:G
Last Name:PEREZ RIVERA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 CAGUANA ST.
Mailing Address - Street 2:TABAIBA TOWER APARTMENTS #401
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2706 AVE MARUCA
Practice Address - Street 2:AVE MARUCA & PR2
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728
Practice Address - Country:US
Practice Address - Phone:787-812-5978
Practice Address - Fax:787-812-5966
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6756183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist