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General NPI Number Information
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NPI Number | 1003727793
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Entity Type | Individual
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Provider Name | JACOB RIVARD DC
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Gender | Male
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Dates
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Enumeration Date | 09/14/2026
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Last Update Date | 09/14/2026
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Provider Practice Location Address
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Address Line | 800 W PLATT ST STE 2
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City | TAMPA
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State | FL
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Zip | 33606-4112
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Country | US
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Telephone | 813-515-5007
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Fax | 813-515-5079
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Provider Business Mailing Address
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Address Line | 6757 16TH TER N APT 385
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City | SAINT PETERSBURG
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State | FL
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Zip | 33710-5450
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Country | US
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Telephone | 906-792-9415
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 16126
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License Number State | FL
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