Healthcare Provider Details

I. General information

NPI: 1811193949
Provider Name (Legal Business Name): ARMANDO J RIVERO APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15974 SW 151ST TER
MIAMI FL
33196-5740
US

IV. Provider business mailing address

15974 SW 151ST TER
MIAMI FL
33196-5740
US

V. Phone/Fax

Practice location:
  • Phone: 786-306-7166
  • Fax:
Mailing address:
  • Phone: 786-306-7166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number05-179
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11003868
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: