Individual
MR. JAIRO ERNESTO RIVEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
8019 LAKE DR APT 204, DORAL, FL 33166-7837
(786) 694-0880
Mailing address
8019 LAKE DR APT 204, DORAL, FL 33166-7837
(786) 694-0880
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5164421
FL
Other
Enumeration date
01/09/2015
Last updated
09/18/2024
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