Individual
JUAN J RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
2835 W DE LEON ST, SUITE 101, TAMPA, FL 33609-4168
(813) 254-6592
(813) 254-3634
Mailing address
2835 W DE LEON ST, SUITE 101, TAMPA, FL 33609-4168
(813) 254-6592
(813) 254-3634
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO2416
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2700454
UNITED HEALTHCARE
FL
01
—
65329
BLUE CROSS BLUE SHIELD
FL
Enumeration date
12/27/2005
Last updated
08/30/2011
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