Provider Demographics
NPI:1265198253
Name:BURGOS RIVERA, YULIANA
Entity type:Individual
Prefix:
First Name:YULIANA
Middle Name:
Last Name:BURGOS RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 65 BOX 6066
Mailing Address - Street 2:
Mailing Address - City:PATILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00723-9326
Mailing Address - Country:US
Mailing Address - Phone:787-342-4283
Mailing Address - Fax:
Practice Address - Street 1:18 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:PATILLAS
Practice Address - State:PR
Practice Address - Zip Code:00723-2607
Practice Address - Country:US
Practice Address - Phone:787-839-2730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-13
Last Update Date:2021-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist