Provider Demographics
NPI:1821727009
Name:PEREIRA RIVERA, PAOLA KRISTAL (PHARMD)
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:KRISTAL
Last Name:PEREIRA 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:CAGUAS NORTE
Mailing Address - Street 2:CALLE FLORENCIA G12
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:939-579-2654
Mailing Address - Fax:
Practice Address - Street 1:CAGUAS NORTE
Practice Address - Street 2:CALLE FLORENCIA G12
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:939-579-2654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2023-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8174183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist