Provider Demographics
NPI:1942855929
Name:RIVERON, KRISTA MARIE (PHARMD, JD, MS)
Entity Type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:MARIE
Last Name:RIVERON
Suffix:
Gender:F
Credentials:PHARMD, JD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8793 WELLINGTON VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33411-5309
Mailing Address - Country:US
Mailing Address - Phone:305-491-2307
Mailing Address - Fax:
Practice Address - Street 1:8793 WELLINGTON VIEW DR
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33411-5309
Practice Address - Country:US
Practice Address - Phone:305-491-2307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS59607183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist