Healthcare Provider Details

I. General information

NPI: 1497281224
Provider Name (Legal Business Name): ERIKA RODRIGUEZ RIVERA MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 08/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 MARINER BLVD
SPRING HILL FL
34609
US

IV. Provider business mailing address

3837 LANGDRUM DR
WESLEY CHAPEL FL
33543-7903
US

V. Phone/Fax

Practice location:
  • Phone: 352-683-2120
  • Fax:
Mailing address:
  • Phone: 787-614-7888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number5020
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ8431
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: