Healthcare Provider Details

I. General information

NPI: 1235096884
Provider Name (Legal Business Name): CHRISTIAN RUBEN DE LEON RIVERA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 149 KM 3.0 BO COTTO SUR
MANATI PR
00674
US

IV. Provider business mailing address

3150 CALLE MONTE COQUI
MANATI PR
00674-6315
US

V. Phone/Fax

Practice location:
  • Phone: 787-854-2041
  • Fax: 787-884-9039
Mailing address:
  • Phone: 787-854-2041
  • Fax: 787-884-9039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number008187
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: