Individual
ANTONIO J RIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPAS,PA-C
Contact information
Practice address
14240 SW 29TH ST, MIAMI, FL 33175-6544
(786) 263-2057
Mailing address
2015 NW 1ST AVE, MIAMI, FL 33127-4901
(305) 572-2026
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 9102220
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA 9102220
PA LICENSE
FL
Enumeration date
07/27/2009
Last updated
07/27/2009
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