Individual
JOHNNY RIVERA-VARGAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1427 UMBRELLA TREE DR, EDGEWATER, FL 32132-2413
(407) 687-3147
Mailing address
1427 UMBRELLA TREE DR, EDGEWATER, FL 32132-2413
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
01/09/2020
Last updated
01/09/2020
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