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NPI Code Detail

MEDICARE: GAMALIEL RIVERA

MEDICARE: GAMALIEL RIVERA
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
1101YM0800XMental Health CounselorMH 1165FL
2106H00000XMarriage & Family TherapistMT 784FL

General Provider Information

NPI Number : 1851534648
Entity Type Code : Individual
Provider Name (Legal Business Name) : GAMALIEL RIVERA
Provider Business Mailing Address
First Line : PO BOX 371412
Second Line :
City : MIAMI
State : FL
Zip : 33137-1412
Country : US
Telephone Number : 954-885-9500
Fax Number :
Provider Business Practice Location Address
First Line : 3349 N UNIVERSITY DR
Second Line : SUITE 4
City : HOLLYWOOD
State : FL
Zip : 33024-9000
Country : US
Telephone Number : 954-885-9500
Fax Number : 954-885-9444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2009
Last Update Date : 04/09/2009

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Directions to “ GAMALIEL RIVERA ” Practice Location

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