Individual
LIZ ENEIDA RIVERA BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 ROGERS ST NE APT 3315, ATLANTA, GA 30317-1090
(787) 502-5303
Mailing address
105 ROGERS ST NE APT 3315, ATLANTA, GA 30317-1090
(787) 502-5303
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
22260
PR
207P00000X
Emergency Medicine Physician
34105-R
PR
207P00000X
Emergency Medicine Physician
Primary
92336
GA
Other
Enumeration date
05/17/2019
Last updated
01/21/2025
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