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NPI Code Detail

MEDICARE: DANIELLA MARIE RIVERA

MEDICARE: DANIELLA MARIE RIVERA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083363394
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLA MARIE RIVERA
Provider Business Mailing Address
First Line : 300 INTERNATIONAL PKWY STE 200
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-5028
Country : US
Telephone Number : 866-610-0580
Fax Number :
Provider Business Practice Location Address
First Line : 2305 GLENWOOD DR
Second Line :
City : WINTER PARK
State : FL
Zip : 32792-3313
Country : US
Telephone Number : 321-587-4525
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2022
Last Update Date : 03/22/2022

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Directions to “ DANIELLA MARIE RIVERA ” Practice Location

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