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1316139959 NPI number — MIGUEL A RIVERA M.D.

NPI Number: 1316139959
Health Care Provider/Practitioner: MIGUEL A RIVERA M.D.

Information about “1316139959” NPI (MIGUEL A RIVERA M.D.) exists in 1316139959 in HTML format HTML  |  1316139959 in plain Text format TXT  |  1316139959 in PDF (Portable Document Format) PDF  |  1316139959 in an XML format XML  formats.

NPI Number : 1316139959 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1316139959",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RIVERA",
    "FirstName": "MIGUEL",
    "MiddleName": "A",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "RIVERA-VELAZQUEZ",
    "OtherFirstName": "MIGUEL",
    "OtherMiddleName": "A",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "M.D.",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "1285 36TH ST STE 100",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "VERO BEACH",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32960-6587",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "772-778-2009",
    "MailingAddressFaxNumber": "772-778-2910",
    "FirstLinePracticeLocationAddress": "1986 35TH AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "VERO BEACH",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32960-2533",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "772-360-4306",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/17/2007",
    "LastUpdateDate": "10/26/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2081P2900X",
        "TaxonomyName": "Pain Medicine (Physical Medicine & Rehabilitation) Physician",
        "LicenseNumber": "ME109841",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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