Provider Demographics
NPI:1972316727
Name:RIVERA LOPERENA, CORALYS NICOLE (PHARMD)
Entity type:Individual
Prefix:
First Name:CORALYS
Middle Name:NICOLE
Last Name:RIVERA LOPERENA
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:PO BOX 1015
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-1015
Mailing Address - Country:US
Mailing Address - Phone:787-603-1233
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 3088
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00605-3088
Practice Address - Country:US
Practice Address - Phone:787-882-0135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS678611835P0018X
PR81841835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist