Healthcare Provider Details

I. General information

NPI: 1194881722
Provider Name (Legal Business Name): NAYDA MERCEDES RIVERA RPH.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NAYDA RIVERA RPH.

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 CALLE AMBAR LOS PRADOS SUR
DORADO PR
00646-9645
US

IV. Provider business mailing address

88 CALLE AMBAR LOS PRADOS SUR
DORADO PR
00646-9645
US

V. Phone/Fax

Practice location:
  • Phone: 787-796-0799
  • Fax:
Mailing address:
  • Phone: 787-796-0799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4286
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: