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Individual

MR. JOSEPH LIONEL RIVAS SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 542-3441
Mailing address
7925 GULF RD S, JACKSONVILLE, FL 32244-2524
(904) 771-2211

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
05/04/2007
Last updated
07/08/2007
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