Healthcare Provider Details
I. General information
NPI: 1609803832
Provider Name (Legal Business Name): ALBERTO RIVERA SANCHEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/26/2006
Last Update Date: 02/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1170 S SEMORAN BLVD
ORLANDO FL
32807-1458
US
IV. Provider business mailing address
5365 W ATLANTIC AVE STE 504
DELRAY BEACH FL
33484-8194
US
V. Phone/Fax
- Phone: 407-622-7246
- Fax: 407-599-7246
- Phone: 561-241-9300
- Fax: 561-241-9339
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | ME125319 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2081P2900X |
| Taxonomy | Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | ME125319 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | ME125319 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: