Individual
MR. KEVIN OMAR RIVERA SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
5242 BRACKS LANDING DR # 5242, SAINT CLOUD, FL 34771-8064
(787) 383-1437
Mailing address
5242 BRACKS LANDING DR # 5242, SAINT CLOUD, FL 34771-8064
(787) 383-1437
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
9458076
FL
Other
Enumeration date
02/17/2021
Last updated
02/18/2021
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