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General NPI Number Information
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NPI Number | 1700203601
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Entity Type | Organization
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Legal Business Name | RIVERVIEW COMMUNITY MENTAL HEALTH CENTER LLC
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Dates
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Enumeration Date | 03/28/2014
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Last Update Date | 01/18/2021
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Provider Practice Location Address
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Address Line | 865 SE MONTEREY COMMONS BLVD
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City | STUART
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State | FL
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Zip | 34996-3337
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Country | US
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Telephone | 772-266-4713
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Fax | 772-872-6235
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Provider Business Mailing Address
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Address Line | 865 SE MONTEREY COMMONS BLVD
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City | STUART
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State | FL
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Zip | 34996-3337
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Country | US
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Telephone | 772-266-4713
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Fax | 772-888-9082
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Authorized Official
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Title or Position | OWNER
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Name | DR. GERARDO F OLIVERA
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Credential | MD
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Telephone | 772-266-4713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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