MEDICARE: CHELIMAR TRAVIESO 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
1	106S00000X	Behavior Technician		FL

General Provider Information

NPI Number	:	1275498099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELIMAR TRAVIESO RIVERA

Provider Business Mailing Address
First Line	:	11910 BOYETTE RD
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33569-5601
Country	:	US
Telephone Number	:	813-814-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	11910 BOYETTE RD
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33569-5601
Country	:	US
Telephone Number	:	813-814-2000
Fax Number	:

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

Provider Enumeration Date	:	12/23/2025
Last Update Date	:	12/23/2025

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Directions to “ CHELIMAR TRAVIESO RIVERA ” Practice Location

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