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General NPI Number Information
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NPI Number | 1629166939
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Entity Type | Individual
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Provider Name | JOSE RIVAS MD
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Gender | Male
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 4420 SW 136TH PL
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City | MIAMI
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State | FL
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Zip | 33175-3721
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Country | US
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Telephone | 305-338-5046
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Fax |
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Provider Business Mailing Address
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Address Line | 1951 SW 172ND AVE STE 301
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City | MIRAMAR
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State | FL
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Zip | 33029-5614
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Country | US
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Telephone | 954-510-5454
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Fax | 954-589-0960
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME93735
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License Number State | FL
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