Healthcare Provider Details

I. General information

NPI: 1407789068
Provider Name (Legal Business Name): RIVERA FAMILY MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4024 GARIENDA AVENUE
SEBRING FL
33872
US

IV. Provider business mailing address

4024 GARIENDA AVENUE
SEBRING FL
33872
US

V. Phone/Fax

Practice location:
  • Phone: 904-658-0662
  • Fax:
Mailing address:
  • Phone: 904-658-0662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: REBECA RIVERA
Title or Position: PRACTICE OWNER
Credential: APRN
Phone: 863-202-5997