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General NPI Number Information
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NPI Number | 1891227625
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Entity Type | Individual
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Provider Name | DIEGO ALEXANDER RIVEROS
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Gender | Male
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Dates
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Enumeration Date | 03/30/2017
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 1 TAMPA GENERAL CIR
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City | TAMPA
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State | FL
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Zip | 33606-3571
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Country | US
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Telephone | 813-844-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 6860 30TH AVE N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33710-3002
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Country | US
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Telephone | 352-260-2226
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 29727
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD470775
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207PS0010X
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Taxonomy Name | Sports Medicine (Emergency Medicine) Physician
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License Number | ME138836
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License Number State | FL
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