Healthcare Provider Details

I. General information

NPI: 1891619219
Provider Name (Legal Business Name): MEDCORE MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2219 CAXTON AVE
CLERMONT FL
34711-5926
US

IV. Provider business mailing address

2219 CAXTON AVE
CLERMONT FL
34711-5926
US

V. Phone/Fax

Practice location:
  • Phone: 929-684-6657
  • Fax: 929-684-6657
Mailing address:
  • Phone: 929-684-6657
  • Fax: 929-684-6657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: VIVIANA MILAGROS RIERA
Title or Position: CEO
Credential: OWNER
Phone: 929-684-6657