Individual
DR. NYDIA GRICELLE DELTORO RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, WCC. DWC, CWS
Contact information
Practice address
1120 CARLTON AVE, LAKE WALES, FL 33853-4348
(863) 270-4546
Mailing address
12171 SW 268TH ST, HOMESTEAD, FL 33032-8001
(305) 278-0200
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
13203
PR
208D00000X
General Practice Physician
Primary
ACN634
FL
Other
Enumeration date
11/30/2005
Last updated
03/03/2022
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