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General NPI Number Information
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NPI Number | 1265348692
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Entity Type | Individual
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Provider Name | VICTORIA RIVERA
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Gender | Female
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Dates
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Enumeration Date | 08/24/2026
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Last Update Date | 08/24/2026
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Provider Practice Location Address
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Address Line | 1515 SARNO RD BLDG B
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City | MELBOURNE
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State | FL
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Zip | 32935-5272
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Country | US
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Telephone | 615-324-5768
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Fax | 615-932-8776
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Provider Business Mailing Address
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Address Line | 7960 COUNTY ROAD 208
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-0381
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Country | US
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Telephone | 904-687-9344
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ISW20881
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License Number State | FL
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