Provider Demographics
NPI:1548686017
Name:RIVERA, CRYSTAL EDEN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:EDEN
Last Name:RIVERA
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:PO BOX 506
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-0506
Mailing Address - Country:US
Mailing Address - Phone:787-719-7828
Mailing Address - Fax:787-709-4786
Practice Address - Street 1:CARRETERA 308 KM 5.1 BARRIO MIRADERO
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-4860
Practice Address - Country:US
Practice Address - Phone:787-719-7828
Practice Address - Fax:787-709-4786
Is Sole Proprietor?:No
Enumeration Date:2014-03-08
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43025183500000X
PR5527183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist