Provider Demographics
NPI:1477636306
Name:RIVERA, MARIA ISABEL (PHARM)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ISABEL
Last Name:RIVERA
Suffix:
Gender:F
Credentials:PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CHALETS DE SAN FERNANDO
Mailing Address - Street 2:APT 401
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-769-2566
Mailing Address - Fax:
Practice Address - Street 1:GG19 CALLE PANDORA
Practice Address - Street 2:MANSIONES DE CAROLINA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-8113
Practice Address - Country:US
Practice Address - Phone:787-769-2566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist