Healthcare Provider Details

I. General information

NPI: 1083323562
Provider Name (Legal Business Name): DAVID AMARAN RIVERO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2022
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9442 NW 120TH ST APT 425
HIALEAH GARDENS FL
33018-4194
US

IV. Provider business mailing address

9442 NW 120TH ST APT 425
HIALEAH GARDENS FL
33018-4194
US

V. Phone/Fax

Practice location:
  • Phone: 305-764-2696
  • Fax:
Mailing address:
  • Phone: 305-764-2696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-88882
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: