Healthcare Provider Details

I. General information

NPI: 1346305521
Provider Name (Legal Business Name): BRENDA E. RIVERA OLMEDA PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 CALLE MUNOZ RIVERA PUEBLO
GUAYNABO PR
00969-5705
US

IV. Provider business mailing address

URB. QUINTAS REALES PRINCESA MARGARITA H-3 STREET
GUAYNABO PR
00969
US

V. Phone/Fax

Practice location:
  • Phone: 787-720-2196
  • Fax: 787-720-2196
Mailing address:
  • Phone: 787-790-3049
  • Fax: 787-720-2196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3652
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: