Provider Demographics
NPI:1538299573
Name:RIVERA, DOLORES MARGARITA
Entity Type:Individual
Prefix:MISS
First Name:DOLORES
Middle Name:MARGARITA
Last Name:RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB.EL PLANTIO
Mailing Address - Street 2:CALLE BUCARE A-37B
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-251-6756
Mailing Address - Fax:787-721-5349
Practice Address - Street 1:URB.EL PLANTIO
Practice Address - Street 2:CALLE BUCARE A-37B
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-251-6756
Practice Address - Fax:787-721-5349
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR883183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR883OtherPHARMACIST ASSISTANT