Provider Demographics
NPI:1710042239
Name:RIVERA, XOCHITL P (RPH)
Entity Type:Individual
Prefix:MRS
First Name:XOCHITL
Middle Name:P
Last Name:RIVERA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 CALLE CONCEPCION VERA
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-5016
Mailing Address - Country:US
Mailing Address - Phone:787-818-4839
Mailing Address - Fax:
Practice Address - Street 1:835 CALLE CONCEPCION VERA
Practice Address - Street 2:CARR 110 KM 10.5
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-5016
Practice Address - Country:US
Practice Address - Phone:787-818-4839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4981183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist