MEDICARE: MRS. ISAMAR VANESSA RIVERA-FELICIANO PT

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	225100000X	Physical Therapist	PT32093	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	:	1588692206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ISAMAR VANESSA RIVERA-FELICIANO PT

Provider Business Mailing Address
First Line	:	2787 MEAD AVE
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-7939
Country	:	US
Telephone Number	:	407-765-6145
Fax Number	:

Provider Business Practice Location Address
First Line	:	9145 NARCOOSSEE RD STE A204
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-5768
Country	:	US
Telephone Number	:	407-273-1714
Fax Number	:

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

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	02/20/2026

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