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NPI Code Detail

MEDICARE: LAKECIA RIVERA APRN, FNP-C

MEDICARE: LAKECIA RIVERA APRN, FNP-C
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 PractitionerAPRN11032351FL

General Provider Information

NPI Number : 1659116390
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAKECIA RIVERA APRN, FNP-C
Provider Business Mailing Address
First Line : 167 WALNUT CREST RUN
Second Line :
City : SANFORD
State : FL
Zip : 32771-7987
Country : US
Telephone Number : 419-265-1544
Fax Number :
Provider Business Practice Location Address
First Line : 712 W 25TH ST
Second Line :
City : SANFORD
State : FL
Zip : 32771-4232
Country : US
Telephone Number : 407-402-2303
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2024
Last Update Date : 06/25/2024

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Directions to “ LAKECIA RIVERA APRN, FNP-C” Practice Location

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