Individual
MR. LUIS ALBERTO RIVERA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
1701 NE 127TH ST, NORTH MIAMI, FL 33181-2518
(305) 892-7631
Mailing address
11216 NW 6TH ST, MIAMI, FL 33172-3556
(305) 484-5619
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 4441
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000023050
BOC CERTIFICATION
FL
01
—
AL 4441
FLORIDA ATHLETIC TRAINING LICENSE
FL
Enumeration date
09/16/2016
Last updated
09/16/2016
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