Healthcare Provider Details

I. General information

NPI: 1447183561
Provider Name (Legal Business Name): KEVIN JOSEPH RIVERS PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2539 BARWICK ST
ORLANDO FL
32824-4207
US

IV. Provider business mailing address

2539 BARWICK ST
ORLANDO FL
32824-4207
US

V. Phone/Fax

Practice location:
  • Phone: 919-710-9989
  • Fax:
Mailing address:
  • Phone: 919-710-9989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number45975
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: