Healthcare Provider Details

I. General information

NPI: 1285862128
Provider Name (Legal Business Name): JESSICA RIOS-FLORES LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA RIOS-FLORES LCSW-R

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11705 BOYETTE RD STE 203
RIVERVIEW FL
33569-5533
US

IV. Provider business mailing address

11705 BOYETTE RD STE 203
RIVERVIEW FL
33569-5533
US

V. Phone/Fax

Practice location:
  • Phone: 813-535-0881
  • Fax:
Mailing address:
  • Phone: 813-535-0881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number080877
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: