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General NPI Number Information
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NPI Number | 1164808101
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Entity Type | Individual
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Provider Name | MR. LUIS FERNANDO RIVERA-MENDOZA
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Gender | Male
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Dates
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Enumeration Date | 07/31/2015
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Last Update Date | 07/31/2015
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Provider Practice Location Address
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Address Line | DK5 CALLE CERROS RIO HONDO 4
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City | BAYAMON
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State | PR
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Zip | 00961-3303
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Country | US
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Telephone | 787-964-2861
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Fax |
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Provider Business Mailing Address
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Address Line | DK5 CALLE CERROS RIO HONDO 4
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City | BAYAMON
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State | PR
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Zip | 00961-3303
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 8659
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License Number State | PR
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