Organization
LUIS A RIVES MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARON E DIAZ (PRACTICE MANAGER)
(239) 287-1493
Entity
Organization
Contact information
Practice address
2430 VANDERBILT BEACH RD STE 108-273, NAPLES, FL 34109
(239) 287-1493
(239) 244-9357
Mailing address
2430 VANDERBILT BEACH RD STE 108-273, NAPLES, FL 34109-2654
(239) 287-1493
(239) 244-9357
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME70436
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261295000
—
FL
01
—
DA5324
MEDICARE RAILROAD
FL
01
—
R1SK1
FLORIDA BLUE GROUP NUMBER
FL
Enumeration date
04/28/2006
Last updated
08/05/2019
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