Healthcare Provider Details

I. General information

NPI: 1316860018
Provider Name (Legal Business Name): PAOLA KRYSTAL RIVERA COLON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FARMACIA REY #19 CENTRO COMERCIAL VILLA FONTANA LOCAL 1 AVE SANCHEZ OSOR
CAROLINA PR
00983
US

IV. Provider business mailing address

47 CALLE ILUSION # 1Y2
VEGA ALTA PR
00692-9049
US

V. Phone/Fax

Practice location:
  • Phone: 787-257-1444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: