Individual
MS. STEPHANIE A RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
7932 W SAND LAKE RD STE 202, ORLANDO, FL 32819-7299
(407) 846-7546
(321) 206-5419
Mailing address
PO BOX 690609, ORLANDO, FL 32869-0609
(407) 846-7546
(321) 206-5419
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAT 9105625
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006778500
—
FL
Enumeration date
11/02/2010
Last updated
02/28/2017
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