# ROGER RIVERA NP PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mente Suave Psychiatry & Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801593801
- **Authorized official:** ROGER RIVERA APRN (CEO)
- **Authorized official phone:** (407) 753-1500

## Contact information

- **Practice address:** 3495 W VINE ST, KISSIMMEE, FL 34741-4668
- **Practice address phone:** (407) 753-1500
- **Practice address fax:** (321) 710-1767
- **Mailing address:** 3495 W VINE ST, KISSIMMEE, FL 34741-4668
- **Mailing address phone:** (407) 753-1500
- **Mailing address fax:** (321) 710-1767

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WP0808X | Psychiatric/Mental Health Registered Nurse | — | NULL | — |
| 163WP0808X | Psychiatric/Mental Health Registered Nurse | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/09/2023
- **Last updated:** 05/10/2023