Individual
DUSTIN RYAN RIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12600 CREEKSIDE LN STE 2, FORT MYERS, FL 33919-3353
(239) 343-9235
(239) 343-4008
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9235
(239) 343-4008
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
ME154923
FL
208M00000X
Hospitalist Physician
Primary
ME154923
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114418100
—
FL
Enumeration date
03/19/2018
Last updated
05/15/2025
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