MEDICARE: XIOMARA RIVERA

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
1	183700000X	Pharmacy Technician	7942	PR

General Provider Information

NPI Number	:	1427281211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	XIOMARA RIVERA

Provider Business Mailing Address
First Line	:	PO BOX 322
Second Line	:
City	:	TOA ALTA
State	:	PR
Zip	:	00954-0322
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	CALLE MENDEZ VIGO # 269
Second Line	:
City	:	DORADO
State	:	PR
Zip	:	00646-4924
Country	:	US
Telephone Number	:	787-796-1155
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2009
Last Update Date	:	08/27/2009

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Directions to “ XIOMARA RIVERA ” Practice Location

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