Healthcare Provider Details

I. General information

NPI: 1457266777
Provider Name (Legal Business Name): EMIGDIO RIVERA GUEVARA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: AKIVA BENAV

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 INDIAN CREEK DR STE 106A
MIAMI BEACH FL
33140-3707
US

IV. Provider business mailing address

3801 INDIAN CREEK DR STE 106A
MIAMI BEACH FL
33140-3707
US

V. Phone/Fax

Practice location:
  • Phone: 407-486-9962
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: