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General NPI Number Information
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NPI Number | 1578175360
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Entity Type | Organization
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Legal Business Name | REBECCA M RIVERA APRN LLC
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Dates
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Enumeration Date | 08/21/2020
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Last Update Date | 08/21/2020
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Provider Practice Location Address
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Address Line | 2631 E OAKLAND PARK BLVD STE 110
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City | FORT LAUDERDALE
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State | FL
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Zip | 33306-1607
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Country | US
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Telephone | 954-514-7306
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Fax |
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Provider Business Mailing Address
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Address Line | 2724 NW 124TH AVE
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-8014
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Country | US
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Telephone | 965-860-9992
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | REBECCA MARIA RIVERA
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Credential | APRN
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Telephone | 954-850-9992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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