Healthcare Provider Details

I. General information

NPI: 1235079997
Provider Name (Legal Business Name): GLORIA RIVAS JARDINES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2493 W 78TH ST APT 202
HIALEAH FL
33016-2826
US

IV. Provider business mailing address

2493 W 78TH ST APT 202
HIALEAH FL
33016-2826
US

V. Phone/Fax

Practice location:
  • Phone: 305-975-9727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: