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General NPI Number Information
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NPI Number | 1265889794
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Entity Type | Individual
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Provider Name | NIRZA VICTORIA SISALEMA RIVAS ARNP
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Gender | Female
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Dates
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Enumeration Date | 05/13/2016
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 4950 S LE JEUNE RD
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City | CORAL GABLES
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State | FL
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Zip | 33146-2231
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Country | US
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Telephone | 305-239-5585
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Fax |
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Provider Business Mailing Address
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Address Line | 12271 SW 143RD LN
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City | MIAMI
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State | FL
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Zip | 33186-6021
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Country | US
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Telephone | 941-284-9301
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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 | 11019562
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 15-132
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License Number State | CO
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