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General NPI Number Information
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NPI Number | 1801012109
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Entity Type | Organization
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Legal Business Name | EUGENIO RIVERA DPM PA
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 02/10/2009
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Provider Practice Location Address
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Address Line | 4343 W FLAGLER ST SUITE 400
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City | CORAL GABLES
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State | FL
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Zip | 33134-1586
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Country | US
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Telephone | 305-441-7030
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Fax | 305-441-9484
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Provider Business Mailing Address
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Address Line | 4343 W FLAGLER ST SUITE 400
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City | CORAL GABLES
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State | FL
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Zip | 33134-1586
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Country | US
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Telephone | 305-441-7030
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Fax | 305-441-9484
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Authorized Official
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Title or Position | PRESIDENT
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Name | EUGENIO RIVERA
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Credential | DPM
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Telephone | 305-441-7030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO32909
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License Number State | FL
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