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General NPI Number Information
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NPI Number | 1225167877
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Entity Type | Individual
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Provider Name | ILIA ANGELICA RIVERA
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Gender | Female
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | AVE. LOMAS VERDES, EDIF., UNIVERSIDAD PHOENIX CARRETERA 177, KM. 2.0
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City | BAYAMON
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State | PR
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Zip | 00959
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Country | US
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Telephone | 787-272-4998
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Fax | 787-272-4969
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Provider Business Mailing Address
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Address Line | CALLE 2 # 36 FLAMINGO HILLS
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City | BAYAMON
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State | PR
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Zip | 00957-1717
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Country | US
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Telephone | 787-646-2968
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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 | 0615
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License Number State | PR
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