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Individual

MIGUEL RIVERA III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 266-1000
Mailing address
490 BONTERRA BLVD APT 10-202, FORT WAYNE, IN 46845-0067
(915) 497-1855

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
26030725A
IN
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
71369
TX

Other

Enumeration date
06/24/2024
Last updated
06/24/2024
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