Provider Demographics
NPI:1194504258
Name:JUAN RIVERA, MAYLEIN C (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MAYLEIN
Middle Name:C
Last Name:JUAN RIVERA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR. 863 KM 0.6 BO. PAJAROS BO. CANDELARIA
Mailing Address - Street 2:
Mailing Address - City:TOA BAHA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-620-9611
Mailing Address - Fax:
Practice Address - Street 1:CARR. 863 KM 0.6 BO. PAJAROS BO. CANDELARIA
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-620-9611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS66424183500000X
PR8146183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist