Healthcare Provider Details

I. General information

NPI: 1730728288
Provider Name (Legal Business Name): TIANNA RIVERA-HERNANDEZ RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 CALLE GERARDO NIEVES MERCADO
COMERIO PR
00782-2542
US

IV. Provider business mailing address

57 CALLE PRINCIPAL
BARRANQUITAS PR
00794-1631
US

V. Phone/Fax

Practice location:
  • Phone: 787-875-3550
  • Fax: 787-875-3550
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6104
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: