MEDICARE: DR. PEDRO D RIVERA MORILLO M.D.

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
1	2080A0000X	Pediatric Adolescent Medicine Physician	6598	PR
2	208D00000X	General Practice Physician	ME139355	FL

General Provider Information

NPI Number	:	1902800691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEDRO D RIVERA MORILLO M.D.

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:	305-500-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1586 BRANAN FIELD RD
Second Line	:
City	:	MIDDLEBURG
State	:	FL
Zip	:	32068-8427
Country	:	US
Telephone Number	:	904-282-8000
Fax Number	:	904-282-8044

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	02/13/2026

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