MEDICARE: NOEMI RIVERA MD

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
1	207P00000X	Emergency Medicine Physician	ME0073359	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1265539621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOEMI RIVERA MD

Provider Business Mailing Address
First Line	:	1648 BLUE JAY CIR
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33327-2008
Country	:	US
Telephone Number	:	954-659-2016
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 W 68TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-1804
Country	:	US
Telephone Number	:	305-364-2124
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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Directions to “ NOEMI RIVERA MD” Practice Location

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