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Individual

JESSICA M RIVERA ROMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
CORPORACION DEL FONDO DEL SEGURO DEL ESTADO, CARR #3 65TH INFANTERIA, CAROLINA, PR 00985
(787) 349-9417
Mailing address
PO BOX, 30651, SAN JUAN, PUERTO RICO 00929
(787) 349-9417

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
003542
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4220980
DRIVERS LICENCE
PR
Enumeration date
04/23/2012
Last updated
04/23/2012
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