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NPI Code Detail

MEDICARE: KELVIN DAVID LORENZO RIVERA DPT, PT

MEDICARE: KELVIN DAVID LORENZO RIVERA DPT, 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
1208100000XPhysical Medicine & Rehabilitation Physician37663FL

General Provider Information

NPI Number : 1831834753
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELVIN DAVID LORENZO RIVERA DPT, PT
Provider Business Mailing Address
First Line : 300 AVENUE OF THE CHAMPIONS STE 100
Second Line :
City : PALM BEACH GARDENS
State : FL
Zip : 33418-3615
Country : US
Telephone Number : 561-223-3872
Fax Number :
Provider Business Practice Location Address
First Line : 300 AVENUE OF CHAMPIONS STE 100
Second Line :
City : PALM BEACH GARDENS
State : FL
Zip : 33418-3615
Country : US
Telephone Number : 561-223-3872
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2022
Last Update Date : 05/04/2022

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