MEDICARE: JUAN J 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	174400000X	Specialist	ME104343	FL
2	207RC0000X	Cardiovascular Disease Physician	L9451	TX

General Provider Information

NPI Number	:	1518012616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAN J RIVERA MD

Provider Business Mailing Address
First Line	:	4308 ALTON RD STE 715
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-4568
Country	:	US
Telephone Number	:	305-604-1922
Fax Number	:	833-471-5058

Provider Business Practice Location Address
First Line	:	4308 ALTON ROAD
Second Line	:	SUITE 715
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2891
Country	:	US
Telephone Number	:	305-604-1922
Fax Number	:	305-604-1925

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

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	05/13/2026

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