Healthcare Provider Details

I. General information

NPI: 1124144910
Provider Name (Legal Business Name): EDUARDO RIVERO CPHT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5989 SW 8TH ST
WEST MIAMI FL
33144-5037
US

IV. Provider business mailing address

5330 SW 4TH ST
CORAL GABLES FL
33134-1116
US

V. Phone/Fax

Practice location:
  • Phone: 305-265-3738
  • Fax:
Mailing address:
  • Phone: 305-898-1451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number2101-1212-7909-542
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: