Healthcare Provider Details

I. General information

NPI: 1831024165
Provider Name (Legal Business Name): JUAN ROBERTO RIVERA PACHECO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 AVE JUAN PONCE DE LEON
SAN JUAN PR
00919-1227
US

IV. Provider business mailing address

PO BOX 191227
SAN JUAN PR
00919-1227
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0207X
TaxonomyCompounded Sterile Preparations Pharmacist
License Number6474
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: