Provider Demographics
NPI:1871378786
Name:RIVERA, GLORIMAR
Entity type:Individual
Prefix:MRS
First Name:GLORIMAR
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WALGREENS LAS PIEDRAS
Mailing Address - Street 2:120 CARR 183
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771
Mailing Address - Country:US
Mailing Address - Phone:787-716-7071
Mailing Address - Fax:
Practice Address - Street 1:WALGREENS LAS PIEDRAS
Practice Address - Street 2:120 CARR 183
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771
Practice Address - Country:US
Practice Address - Phone:787-716-7071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program