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General NPI Number Information
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NPI Number | 1902399801
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Entity Type | Individual
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Provider Name | DANIEL ANDRES RIVAS BT
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Gender | Male
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 04/22/2021
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Provider Practice Location Address
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Address Line | 450 N PARK RD STE 400
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6918
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Country | US
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Telephone | 954-925-3191
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Fax |
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Provider Business Mailing Address
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Address Line | 13810 SW 112TH ST APT 103
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City | MIAMI
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State | FL
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Zip | 33186-3211
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Country | US
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Telephone | 716-969-3653
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-21-49323
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License Number State | FL
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