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NPI 1942900386

NPI 1942900386 : GRETER RIVERO : DORAL, FL

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General NPI Number Information
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    NPI Number           |    1942900386
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    Entity Type          |    Individual 
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    Provider Name        |    GRETER RIVERO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/06/2023
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    Last Update Date     |    03/06/2023
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Provider Practice Location Address
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    Address Line         |    10520 NW 26TH ST 
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    City                 |    DORAL
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    State                |    FL
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    Zip                  |    33172-5940
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    Country              |    US
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    Telephone            |    305-364-5182
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    Fax                  |    305-456-6243
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Provider Business Mailing Address
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    Address Line         |    10520 NW 26TH ST 
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    City                 |    DORAL
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    State                |    FL
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    Zip                  |    33172-5940
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    Country              |    US
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    Telephone            |    305-364-5182
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    Fax                  |    305-456-6243
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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        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    0105589
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    License Number State |    FL
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