Individual
RAFAEL DE LA RIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17240 CORTEZ BLVD, BROOKSVILLE, FL 34601-8978
(352) 754-5400
Mailing address
4519 GEORGE RD, STE. 100, TAMPA, FL 33634-7329
(813) 496-1075
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME49426
FL
Other
Enumeration date
09/22/2005
Last updated
01/02/2008
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