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General NPI Number Information
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NPI Number | 1083286793
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Entity Type | Individual
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Provider Name | JENICE RIVERO
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Gender | Female
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Dates
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Enumeration Date | 07/13/2021
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 15190 SW 136TH ST STE 26
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City | MIAMI
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State | FL
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Zip | 33196-2618
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Country | US
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Telephone | 305-503-6723
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Fax |
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Provider Business Mailing Address
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Address Line | 10410 W OKEECHOBEE RD
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-1918
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Country | US
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Telephone | 786-370-8628
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-20-114212
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License Number State | FL
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