Provider Demographics
NPI:1194881722
Name:RIVERA, NAYDA MERCEDES (RPH)
Entity type:Individual
Prefix:MS
First Name:NAYDA
Middle Name:MERCEDES
Last Name:RIVERA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:PROF
Other - First Name:NAYDA
Other - Middle Name:
Other - Last Name:RIVERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:88 CALLE AMBAR
Mailing Address - Street 2:LOS PRADOS SUR
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-9645
Mailing Address - Country:US
Mailing Address - Phone:787-796-0799
Mailing Address - Fax:
Practice Address - Street 1:88 CALLE AMBAR
Practice Address - Street 2:LOS PRADOS SUR
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-9645
Practice Address - Country:US
Practice Address - Phone:787-796-0799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4286183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist