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General NPI Number Information
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NPI Number | 1194442186
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Entity Type | Individual
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Provider Name | MILEYDIS RIVERO FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/20/2022
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Last Update Date | 10/20/2022
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Provider Practice Location Address
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Address Line | 1 SW 129TH AVE STE 205
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-1717
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Country | US
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Telephone | 954-237-3799
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Fax | 954-237-3801
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Provider Business Mailing Address
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Address Line | 18928 NW 63RD COURT CIR
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City | HIALEAH
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State | FL
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Zip | 33015-4732
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Country | US
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Telephone | 305-799-6281
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11022122
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License Number State | FL
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