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General NPI Number Information
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NPI Number | 1316139959
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Entity Type | Individual
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Provider Name | MIGUEL A RIVERA M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/17/2007
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Last Update Date | 10/26/2023
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Provider Practice Location Address
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Address Line | 1986 35TH AVE
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City | VERO BEACH
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State | FL
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Zip | 32960-2533
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Country | US
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Telephone | 772-360-4306
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Fax |
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Provider Business Mailing Address
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Address Line | 1285 36TH ST STE 100
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City | VERO BEACH
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State | FL
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Zip | 32960-6587
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Country | US
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Telephone | 772-778-2009
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Fax | 772-778-2910
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | ME109841
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License Number State | FL
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