Healthcare Provider Details

I. General information

NPI: 1831188259
Provider Name (Legal Business Name): YOLANDA M RIVERA-CAUDILL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 08/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 SW 87TH AVE C-350
MIAMI FL
33173-3570
US

IV. Provider business mailing address

PO BOX 31140
TAMPA FL
33631-3140
US

V. Phone/Fax

Practice location:
  • Phone: 330-527-1471
  • Fax: 305-271-8732
Mailing address:
  • Phone: 954-965-7400
  • Fax: 954-967-6410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME60713
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: