Healthcare Provider Details

I. General information

NPI: 1114128931
Provider Name (Legal Business Name): DR. ROSALLY FELIU RIVERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70ST SANTA CRUZ URB. SANTA CRUZ
BAYAMON PR
00960
US

IV. Provider business mailing address

16ST R14 VERSALLES
BAYAMON PR
00959
US

V. Phone/Fax

Practice location:
  • Phone: 787-740-4747
  • Fax:
Mailing address:
  • Phone: 787-529-9026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4600
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS36200
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: