Healthcare Provider Details

I. General information

NPI: 1962829614
Provider Name (Legal Business Name): LIZ HEYLIGER-RIVERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2014
Last Update Date: 03/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 AVE FENWAL
SAN GERMAN PR
00683-4476
US

IV. Provider business mailing address

C20 CALLE LOS FLAMBOYANES JARDINES DEL CARIBE
MAYAGUEZ PR
00682-6905
US

V. Phone/Fax

Practice location:
  • Phone: 787-892-4492
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6214
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: