Individual
LISANDRA RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8080 W FLAGLER ST, SUITE 3C, MIAMI, FL 33144-2100
(305) 649-7050
Mailing address
13530 SW 112TH PL, MIAMI, FL 33176-5338
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PTA19833
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA19833
DEPARTMENT OF HEALTH
FL
Enumeration date
10/16/2008
Last updated
10/16/2008
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