Provider Demographics
NPI:1871654061
Name:RIVERA, ORLANDO (RPH)
Entity Type:Individual
Prefix:
First Name:ORLANDO
Middle Name:
Last Name:RIVERA
Suffix:
Gender:M
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:PO BOX 4023
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-4023
Mailing Address - Country:US
Mailing Address - Phone:787-891-6969
Mailing Address - Fax:787-891-6969
Practice Address - Street 1:BO CAIMITAL ALTO CARR #2 KM 123.7
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00605
Practice Address - Country:US
Practice Address - Phone:787-891-6969
Practice Address - Fax:787-891-6969
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4813183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist