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General NPI Number Information
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NPI Number | 1982114351
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Entity Type | Individual
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Provider Name | ROSA MATILDE PEREZ RIOS
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Gender | Female
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Dates
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Enumeration Date | 10/11/2017
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Last Update Date | 10/11/2017
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Provider Practice Location Address
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Address Line | 23 CALLE VALLEJO ESQ PINERO LOTE
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City | SAN JUAN
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State | PR
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Zip | 00925-0092
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Country | US
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Telephone | 787-771-3584
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Fax |
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Provider Business Mailing Address
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Address Line | C47 B STREET EXT ALAMEDA
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-485-5156
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2922
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License Number State | PR
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