Provider Demographics
NPI:1891408597
Name:RIVERA, ROSANGELA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROSANGELA
Middle Name:
Last Name: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:CARR 402 KM 2.9 BO QUEBRADA
Mailing Address - Street 2:LARGA
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610
Mailing Address - Country:US
Mailing Address - Phone:787-826-8888
Mailing Address - Fax:
Practice Address - Street 1:402 KM 2.9 BO QUEBRADA
Practice Address - Street 2:LARGA
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610-0061
Practice Address - Country:US
Practice Address - Phone:787-826-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6848183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist