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NPI Code Detail

MEDICARE: DR. DIANA A PAULINO RIVERA PHARM D.

MEDICARE: DR. DIANA A PAULINO RIVERA PHARM D.
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
1183500000XPharmacist5569PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15569OTHERPR5569

General Provider Information

NPI Number : 1124378369
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DIANA A PAULINO RIVERA PHARM D.
Provider Business Mailing Address
First Line : RR 36 BOX 8124
Second Line :
City : SAN JUAN
State : PR
Zip : 00926-9561
Country : US
Telephone Number : 787-349-8547
Fax Number :
Provider Business Practice Location Address
First Line : 150 CALLE F VIZCARRONDO
Second Line :
City : SAN JUAN
State : PR
Zip : 00926-4483
Country : US
Telephone Number : 787-755-1375
Fax Number : 787-755-1340
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2012
Last Update Date : 09/14/2012

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