MEDICARE: ALIXIER GONZALEZ 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	208000000X	Pediatrics Physician	18517	PR
2	208D00000X	General Practice Physician	135843	FL
3	208000000X	Pediatrics Physician	ME135843	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	:	1396239323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALIXIER GONZALEZ RIVERA MD

Provider Business Mailing Address
First Line	:	2151 SW 82ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-1236
Country	:	US
Telephone Number	:	786-960-6164
Fax Number	:

Provider Business Practice Location Address
First Line	:	5378 W 16TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-2165
Country	:	US
Telephone Number	:	305-820-4101
Fax Number	:	305-820-2885

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

Provider Enumeration Date	:	06/22/2018
Last Update Date	:	05/24/2024

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