Individual
MARK DEDIEGO RIVERA MORALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 W OAK ST, KISSIMMEE, FL 34741
(321) 697-1730
(407) 518-3923
Mailing address
700 W OAK ST, KISSIMMEE, FL 34741-6330
(321) 697-1730
(407) 518-3923
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME1559976
FL
Other
Enumeration date
07/23/2018
Last updated
06/09/2022
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