Individual
SUSAN D RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
703 VIRGINIA ST, DUNEDIN, FL 34698-6615
(727) 734-4000
(727) 738-5037
Mailing address
703 VIRGINIA ST, DUNEDIN, FL 34698-6615
(727) 734-4000
(727) 738-5037
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP9415507
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000111033
GROUP ANTHEM
IN
01
—
000000368986
ANTHEM
IN
05
—
016093400
—
FL
01
—
02PZH
BCBS
FL
05
—
200471680
—
IN
01
—
CJ8803
GROUP RR MEDICARE
IN
01
—
P00146163
RR MEDICARE
IN
Enumeration date
11/02/2005
Last updated
07/19/2016
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