Individual
DR. LUIS A RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
181 WEBB DR STE A, DAVENPORT, FL 33837-3964
(863) 419-1235
(863) 419-9525
Mailing address
235 AMBER WAY, KISSIMMEE, FL 34758-4361
(407) 845-0330
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
22656
PR
208D00000X
General Practice Physician
Primary
ACN1422
FL
390200000X
Student in an Organized Health Care Education/Training Program
15610-I
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114971400
—
FL
Enumeration date
03/13/2022
Last updated
01/08/2026
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