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NPI Code Detail

MEDICARE: MRS. JANET RIVERA PT, BA

MEDICARE: MRS. JANET RIVERA PT, BA
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
1225100000XPhysical Therapist1244PR
2225100000XPhysical Therapist23076FL

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 : 1285743864
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JANET RIVERA PT, BA
Provider Business Mailing Address
First Line : 1232 SE 16TH AVE
Second Line :
City : HOMESTEAD
State : FL
Zip : 33035-2208
Country : US
Telephone Number : 954-599-4642
Fax Number :
Provider Business Practice Location Address
First Line : 1990 S CANAL DR
Second Line :
City : HOMESTEAD
State : FL
Zip : 33035-1046
Country : US
Telephone Number : 305-246-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2006
Last Update Date : 07/08/2007

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