Provider Demographics
NPI:1518178466
Name:RIVERA, SORAIDA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SORAIDA
Middle Name:
Last Name: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 1:8932 SW 97TH AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1936
Mailing Address - Country:US
Mailing Address - Phone:305-270-3472
Mailing Address - Fax:
Practice Address - Street 1:8932 SW 97TH AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1936
Practice Address - Country:US
Practice Address - Phone:305-270-3472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPSI16544183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist