1467075333 NPI number — ADRIANA G. PEREZ RIVERA PHARM.D.

Table of content: ADRIANA G. PEREZ RIVERA PHARM.D. (NPI 1467075333)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467075333 NPI number — ADRIANA G. PEREZ RIVERA PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PEREZ RIVERA
Provider First Name:
ADRIANA
Provider Middle Name:
G.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D.
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:
1467075333
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/26/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
259 CAGUANA ST.
Provider Second Line Business Mailing Address:
TABAIBA TOWER APARTMENTS #401
Provider Business Mailing Address City Name:
PONCE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00716
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2706 AVE MARUCA
Provider Second Line Business Practice Location Address:
AVE MARUCA & PR2
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-812-5978
Provider Business Practice Location Address Fax Number:
787-812-5966
Provider Enumeration Date:
05/26/2020

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:  6756 , 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)





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