Individual
MISS GAUDYS RIVAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6269 NW 171ST ST, HIALEAH, FL 33015-4622
(305) 469-3232
Mailing address
6269 NW 171 ST, MIAMI LAKE, FL 33015
(305) 469-3232
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
OT-0005159
FL
Other
Enumeration date
09/02/2011
Last updated
09/02/2011
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