Healthcare Provider Details

I. General information

NPI: 1831689587
Provider Name (Legal Business Name): VIVIANA RIOS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 CELEBRATION BLVD STE 200
CELEBRATION FL
34747-5165
US

IV. Provider business mailing address

1530 CELEBRATION BLVD STE 200
CELEBRATION FL
34747-5165
US

V. Phone/Fax

Practice location:
  • Phone: 407-934-4100
  • Fax:
Mailing address:
  • Phone: 407-934-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC5506
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: