Individual
GLADYS RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5001 SW 20TH ST APT 8305, OCALA, FL 34474-8701
(787) 513-5311
Mailing address
5001 SW 20TH ST APT 8305, OCALA, FL 34474-8701
(787) 513-5311
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303295
—
MA
05
—
1307576
—
MA
01
—
M18463
BLUE CROSS BLUE SHIELD
MA
Enumeration date
10/03/2016
Last updated
04/26/2020
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