1174276430 NPI number — CRISTINA IRAIS GONZALEZ RIVERA PHARMD

Table of content: CRISTINA IRAIS GONZALEZ RIVERA PHARMD (NPI 1174276430)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174276430 NPI number — CRISTINA IRAIS GONZALEZ RIVERA PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GONZALEZ RIVERA
Provider First Name:
CRISTINA
Provider Middle Name:
IRAIS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174276430
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB SAN CARLOS A9
Provider Second Line Business Mailing Address:
CIRCULO SAN JOSE
Provider Business Mailing Address City Name:
AGUADILLA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-505-9479
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR. 402 KM 1.8
Provider Second Line Business Practice Location Address:
BO. MARIAS, ZONA INDUSTRIAL
Provider Business Practice Location Address City Name:
ANASCO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-229-1515
Provider Business Practice Location Address Fax Number:
787-229-1516
Provider Enumeration Date:
01/27/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  007010 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com