Provider Demographics
NPI:1699016253
Name:RIVERA, NORMA YADIRA
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:YADIRA
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:HC 1 BOX 3409
Mailing Address - Street 2:
Mailing Address - City:ARROYO
Mailing Address - State:PR
Mailing Address - Zip Code:00714-9755
Mailing Address - Country:US
Mailing Address - Phone:939-579-0338
Mailing Address - Fax:
Practice Address - Street 1:HC 1 BOX 3409
Practice Address - Street 2:
Practice Address - City:ARROYO
Practice Address - State:PR
Practice Address - Zip Code:00714-9755
Practice Address - Country:US
Practice Address - Phone:939-579-0338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR007945183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician