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General NPI Number Information
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NPI Number | 1578373197
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Entity Type | Individual
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Provider Name | KARLO ANDRES RIVERA
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Gender | Male
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 711 E OAK ST
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City | KISSIMMEE
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State | FL
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Zip | 34744-4573
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Country | US
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Telephone | 407-846-0533
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Fax | 407-518-1730
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Provider Business Mailing Address
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Address Line | 1604 PINE MARSH LOOP
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City | SAINT CLOUD
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State | FL
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Zip | 34771-7408
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Country | US
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Telephone | 787-595-2032
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11043912
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9477172
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License Number State | FL
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