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General NPI Number Information
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NPI Number | 1528835048
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Entity Type | Individual
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Provider Name | MAYRA OLIVA RIVERO
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Gender | Female
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Dates
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Enumeration Date | 12/05/2023
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 7401 W COMMERCIAL BLVD
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City | LAUDERHILL
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State | FL
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Zip | 33319-2129
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Country | US
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Telephone | 954-644-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 9420 W FLAGLER ST APT 208
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City | MIAMI
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State | FL
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Zip | 33174-2024
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Country | US
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Telephone | 786-624-1795
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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 | 11029920
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License Number State | FL
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