Individual
LUIS MANUEL RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
170 CALLE CAMBALACHE, BO PAJAROS CANDELARIA, TOA BAJA, PR 00949
(787) 982-8300
Mailing address
PO BOX 2806, BAYAMON, PR 00960-2806
(787) 233-8928
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
001104
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1672759
DRIVER LICENCE
PR
Enumeration date
06/18/2017
Last updated
06/16/2018
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