Individual
DR. ANTONIO RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
840 EXECUTIVE LN STE 120, ROCKLEDGE, FL 32955-3519
(321) 449-1112
(321) 449-1172
Mailing address
PO BOX 560727, ROCKLEDGE, FL 32956
(321) 449-1112
(321) 449-1172
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME58006
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056326900
—
FL
01
—
12311
BCBS
—
01
—
942315600
CIGNA
—
Enumeration date
08/21/2006
Last updated
05/02/2018
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