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General NPI Number Information
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NPI Number | 1396854949
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Entity Type | Individual
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Provider Name | JOSE RIVAS
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Gender | Male
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 20241 SW 127TH AVE
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City | MIAMI
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State | FL
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Zip | 33177-5119
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Country | US
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Telephone | 305-256-1617
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Fax |
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Provider Business Mailing Address
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Address Line | 13224 SW 212TH ST
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City | MIAMI
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State | FL
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Zip | 33177-7499
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Country | US
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Telephone | 305-331-5314
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT21219
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License Number State | FL
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