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NPI Code Detail

MEDICARE: MRS. ASTRID DAMARIS RIVERA

MEDICARE: MRS. ASTRID DAMARIS RIVERA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183700000XPharmacy Technician2454PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12454OTHERPRPHARMACY TECHNICIAN

General Provider Information

NPI Number : 1023147287
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ASTRID DAMARIS RIVERA
Provider Business Mailing Address
First Line : MONSERRATE TOWERS
Second Line : TORRE 1 APT. 208
City : CAROLINA
State : PR
Zip : 00983
Country : US
Telephone Number : 787-753-1972
Fax Number : 787-765-1581
Provider Business Practice Location Address
First Line : 115 CALLE RODRIGO DE TRIANA
Second Line : EL VEDADO
City : SAN JUAN
State : PR
Zip : 00918-3207
Country : US
Telephone Number : 787-250-6203
Fax Number : 787-765-1581
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2007
Last Update Date : 07/08/2007

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