Healthcare Provider Details

I. General information

NPI: 1588578454
Provider Name (Legal Business Name): MARIANGELY RIVERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2685 SW 32ND PL STE 400
OCALA FL
34471-7866
US

IV. Provider business mailing address

2685 SW 32ND PL STE 400
OCALA FL
34471-7866
US

V. Phone/Fax

Practice location:
  • Phone: 352-624-0004
  • Fax: 352-624-3090
Mailing address:
  • Phone: 352-624-0004
  • Fax: 352-624-3090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: