Individual
JAXAIRA RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2743 CARMEL CT, KISSIMMEE, FL 34746-3268
(407) 283-2765
Mailing address
2743 CARMEL CT, KISSIMMEE, FL 34746-3268
(407) 283-2765
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CBHCM.0105254-P
FL
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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