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General NPI Number Information
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NPI Number | 1386654820
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Entity Type | Individual
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Provider Name | MRS. CARMEN SOEORRO RIVERA
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Gender | Female
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 13A 17 STREET URB SANTA MONICA
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City | BAYAMON
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State | PR
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Zip | 00956
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Country | US
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Telephone | 787-786-0455
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Fax | 787-787-4502
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Provider Business Mailing Address
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Address Line | PO BOX 274
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City | COMERIO
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State | PR
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Zip | 00782
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Country | US
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Telephone | 787-875-2105
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Fax | 787-857-6066
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2851
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License Number State | PR
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