Provider Demographics
NPI:1538617717
Name:RIVERA MATOS, SOLYMAR (PHARMD)
Entity type:Individual
Prefix:
First Name:SOLYMAR
Middle Name:
Last Name:RIVERA MATOS
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:HC 2 BOX 6535
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-9239
Mailing Address - Country:US
Mailing Address - Phone:787-385-9680
Mailing Address - Fax:
Practice Address - Street 1:800 AVE JESUS T PINERO
Practice Address - Street 2:SUITE 102
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-535-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist