MEDICARE: REBECA RIVERA

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	1041C0700X	Clinical Social Worker	SW11043	FL

General Provider Information

NPI Number	:	1578986436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECA RIVERA

Provider Business Mailing Address
First Line	:	17680 93RD RD N
Second Line	:
City	:	LOXAHATCHEE
State	:	FL
Zip	:	33470-2697
Country	:	US
Telephone Number	:	917-538-3385
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 S AUSTRALIAN AVE STE 422
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-5004
Country	:	US
Telephone Number	:	561-331-2472
Fax Number	:

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

Provider Enumeration Date	:	01/29/2014
Last Update Date	:	03/14/2024

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