Healthcare Provider Details

I. General information

NPI: 1396239323
Provider Name (Legal Business Name): ALIXIER GONZALEZ RIVERA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2018
Last Update Date: 05/24/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5378 W 16TH AVE
HIALEAH FL
33012-2165
US

IV. Provider business mailing address

2151 SW 82ND AVE
MIAMI FL
33155-1236
US

V. Phone/Fax

Practice location:
  • Phone: 305-820-4101
  • Fax: 305-820-2885
Mailing address:
  • Phone: 786-960-6164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number18517
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number135843
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME135843
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: