Provider Demographics
NPI:1447636717
Name:RIVERA OCASIO, VIVIAN (PHARM D)
Entity type:Individual
Prefix:
First Name:VIVIAN
Middle Name:
Last Name:RIVERA OCASIO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9410 LOS ROMEROS AVENUE MONTEHIEDRA TOWN CENTER
Mailing Address - Street 2:
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00926
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9410 LOS ROMEROS AVENUE MONTEHIEDRA TOWN CENTER
Practice Address - Street 2:
Practice Address - City:RIO PIEDRAS
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00926
Practice Address - Country:UM
Practice Address - Phone:787-720-5155
Practice Address - Fax:1847-396-2956
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5576183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist