Healthcare Provider Details

I. General information

NPI: 1316865801
Provider Name (Legal Business Name): MARIANNA RIESER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 JOHNSON ST
HOLLYWOOD FL
33021-5421
US

IV. Provider business mailing address

2165 VAN BUREN ST APT 606
HOLLYWOOD FL
33020-5192
US

V. Phone/Fax

Practice location:
  • Phone: 954-265-9955
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835E0208X
TaxonomyEmergency Medicine Pharmacist
License NumberPS67573
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: