Individual
EVER I RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1114 BELL SHOALS RD, BRANDON, FL 33511-8813
(813) 940-8140
(813) 940-8148
Mailing address
1114 BELL SHOALS RD, BRANDON, FL 33511-8813
(813) 940-8140
(813) 940-8148
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME88369
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340392100
—
FL
01
—
53755
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/28/2006
Last updated
06/12/2020
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