Individual
MR. SANTIAGO J RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3420 NW 112TH TER, CORAL SPRINGS, FL 33065-7094
(954) 345-5117
(954) 345-5459
Mailing address
3420 NW 112TH TER, CORAL SPRINGS, FL 33065-7094
(954) 345-5117
(954) 345-5459
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
PTA11718
FL
Other
Enumeration date
04/22/2007
Last updated
07/08/2007
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