MEDICARE: LOYDA RIVERO

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

General Provider Information

NPI Number	:	1285187815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOYDA RIVERO

Provider Business Mailing Address
First Line	:	4421 NW 169TH TER
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-4324
Country	:	US
Telephone Number	:	786-328-6300
Fax Number	:

Provider Business Practice Location Address
First Line	:	4421 NW 169TH TER
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-4324
Country	:	US
Telephone Number	:	786-328-6300
Fax Number	:

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

Provider Enumeration Date	:	08/01/2016
Last Update Date	:	08/28/2019

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Directions to “ LOYDA RIVERO ” Practice Location

Language	Start Address	Practice Location

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