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General NPI Number Information
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NPI Number | 1780046623
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Entity Type | Individual
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Provider Name | MRS. MIRIAM VANESSA RIVERA
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Gender | Female
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Dates
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Enumeration Date | 03/21/2016
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Last Update Date | 03/21/2016
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Provider Practice Location Address
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Address Line | 900 CALLE CERRA PARADA 15 FINAL
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City | SANTURCE
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State | PR
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Zip | 00907
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Country | US
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Telephone | 787-722-4600
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Fax | 787-723-4068
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Provider Business Mailing Address
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Address Line | HC 4 BOX 5340
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City | GUAYNABO
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State | PR
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Zip | 00971-9514
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Country | US
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Telephone | 787-614-2606
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Fax | 787-723-4068
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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 | 9874
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License Number State | PR
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