MEDICARE: DR. FLAVIA VAN RIEL 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	2084P0800X	Psychiatry Physician	ME 86943	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	:	1376544791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FLAVIA VAN RIEL MD

Provider Business Mailing Address
First Line	:	4315 ALTON RD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2850
Country	:	US
Telephone Number	:	305-401-8899
Fax Number	:	305-721-1692

Provider Business Practice Location Address
First Line	:	975 ARTHUR GODFREY RD
Second Line	:	SUITE 301
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3329
Country	:	US
Telephone Number	:	305-401-8899
Fax Number	:	305-721-1692

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	05/29/2013

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