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Organization
JUAN I RIVERA
Active
Organization
JUAN I RIVERA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN I RIVERA M.D. (OWNER)
(941) 639-1640
Entity
Organization
Contact information
Practice address
315 E OLYMPIA AVE, 111, PUNTA GORDA, FL 33950-3833
(941) 639-1640
(941) 637-9808
Mailing address
315 E OLYMPIA AVE # 111, PUNTA GORDA, FL 33950-3833
(941) 639-1640
(941) 637-9808
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME050857
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
072052600
—
FL
Enumeration date
07/30/2007
Last updated
01/14/2009
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