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NPI Code Detail

MEDICARE: MAYRA OLIVA RIVERO

MEDICARE: MAYRA OLIVA RIVERO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner11029920FL

General Provider Information

NPI Number : 1528835048
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYRA OLIVA RIVERO
Provider Business Mailing Address
First Line : 9420 W FLAGLER ST APT 208
Second Line :
City : MIAMI
State : FL
Zip : 33174-2024
Country : US
Telephone Number : 786-624-1795
Fax Number :
Provider Business Practice Location Address
First Line : 7401 W COMMERCIAL BLVD
Second Line :
City : LAUDERHILL
State : FL
Zip : 33319-2129
Country : US
Telephone Number : 954-644-8800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2023
Last Update Date : 02/05/2026

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Directions to “ MAYRA OLIVA RIVERO ” Practice Location

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