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NPI Code Detail

MEDICARE: YOLANDA RIVERA LIC

MEDICARE: YOLANDA RIVERA LIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist3937PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1#3937OTHERPRLICENSE PHARMACIST

General Provider Information

NPI Number : 1013003433
Entity Type Code : Individual
Provider Name (Legal Business Name) : YOLANDA RIVERA LIC
Provider Business Mailing Address
First Line : 963 CALLE PUERTO PRINCIPE
Second Line : URB LAS AMERICAS
City : SAN JUAN
State : PR
Zip : 00921-1919
Country : US
Telephone Number : 787-764-2523
Fax Number :
Provider Business Practice Location Address
First Line : 851 CALLE LAFAYETTE
Second Line : PDA 20 ESQ SAN RAFAEL
City : SAN JUAN
State : PR
Zip : 00909-2627
Country : US
Telephone Number : 787-724-3307
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 07/08/2007

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Directions to “ YOLANDA RIVERA LIC” Practice Location

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