Individual
MRS. JESSICA RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
975 BAPTIST WAY STE 101, HOMESTEAD, FL 33033-7600
(786) 243-8660
(786) 533-9643
Mailing address
PO BOX 100905, ATLANTA, GA 30384-0905
(786) 243-8660
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9107463
FL
363AS0400X
Surgical Physician Assistant
PAT9107463
FL
Other
Enumeration date
10/15/2013
Last updated
02/08/2022
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