Individual
MS. IDA RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
150 SPARTAN DR, MAITLAND, FL 32751-3468
(407) 331-8002
(407) 261-0523
Mailing address
8215 SARNOW DR, ORLANDO, FL 32822-7531
(407) 921-0669
(407) 261-0523
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/28/2010
Last updated
10/28/2010
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