Healthcare Provider Details

I. General information

NPI: 1902017536
Provider Name (Legal Business Name): ZORAIDA LOPEZ RIVERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE SANTA CRUZ # 70 URB SANTA CRUZ
BAYAMON PR
00961
US

IV. Provider business mailing address

29 DD10 URB CANA
BAYAMON PR
00957
US

V. Phone/Fax

Practice location:
  • Phone: 787-740-4747
  • Fax:
Mailing address:
  • Phone: 787-799-4247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4001
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: