Organization
FLORIDA STATE NURSE REGISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY RIVERA RN (ADMINISTRATOR)
(140) 744-0287
Entity
Organization
Contact information
Practice address
290 CITRUS TOWER BLVD STE 229, CLERMONT, FL 34711-2786
(522) 616-4753
Mailing address
7003 PRESIDENTS DR STE 800, ORLANDO, FL 32809-5530
(140) 744-0287
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
11/02/2020
Last updated
11/02/2020
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