MEDICARE: VERA MARIE RIVERA NP-C

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	363LF0000X	Family Nurse Practitioner	AC004365	MD
2	363LF0000X	Family Nurse Practitioner	087808-23	NH
3	363LF0000X	Family Nurse Practitioner	5006852	NC
4	363LF0000X	Family Nurse Practitioner	APRN03173	RI
5	363LF0000X	Family Nurse Practitioner	RN2363521	MA
6	363LF0000X	Family Nurse Practitioner	3017587	KY
7	363LF0000X	Family Nurse Practitioner	.0031503	OH
8	363LF0000X	Family Nurse Practitioner	500002202	DC
9	363LF0000X	Family Nurse Practitioner	CNP221133	ME
10	363LF0000X	Family Nurse Practitioner	11013506	FL
11	363LF0000X	Family Nurse Practitioner	101.0136564	VT
12	363LF0000X	Family Nurse Practitioner	53-81049041	KS
13	363LF0000X	Family Nurse Practitioner	LG-0011983	DE

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	:	1619396272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERA MARIE RIVERA NP-C

Provider Business Mailing Address
First Line	:	1300 SW SAINT LUCIE WEST BLVD
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-2109
Country	:	US
Telephone Number	:	866-389-2727
Fax Number	:	401-652-9787

Provider Business Practice Location Address
First Line	:	1300 SW SAINT LUCIE WEST BLVD
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-2109
Country	:	US
Telephone Number	:	772-878-7078
Fax Number	:

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

Provider Enumeration Date	:	04/10/2014
Last Update Date	:	10/11/2025

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