Individual
SANDRA RIVERA-LUCIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
3100 SW 62ND AVE, MIAMI, FL 33155-3009
(305) 666-6511
(305) 662-8291
Mailing address
PO BOX 557367, MIAMI, FL 33255
(786) 624-5845
(786) 624-5881
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME62401
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258193100
—
FL
Enumeration date
11/02/2006
Last updated
09/24/2008
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