Individual
DR. NASIM S DAVID RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 N SEMORAN BLVD STE E, ORLANDO, FL 32807-3562
(407) 823-8421
(407) 823-8195
Mailing address
719 E OAK ST, KISSIMMEE, FL 34744-4580
(407) 846-0533
(407) 518-1730
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
8291
PR
2080A0000X
Pediatric Adolescent Medicine Physician
ACN835
FL
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
ME135709
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5313
FIRST MEDICAL
PR
01
—
99761
TRIPLE S
PR
01
—
ACN835
LICENSE
FL
01
—
ME135709
MEDICAL LICENSE
FL
Enumeration date
03/23/2006
Last updated
02/07/2024
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