Healthcare Provider Details

I. General information

NPI: 1518624907
Provider Name (Legal Business Name): AYEISHA M. QUINONES RIVERA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2021
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

576 AVE. CESAR GONZALEZ SUITE 206
SAN JUAN PR
00918
US

IV. Provider business mailing address

PO BOX 616
CAROLINA PR
00986-0616
US

V. Phone/Fax

Practice location:
  • Phone: 787-777-1120
  • Fax: 787-777-1124
Mailing address:
  • Phone: 787-633-5192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8555
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: