Individual
ISABELLA A RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4731 14TH AVE S, SAINT PETERSBURG, FL 33711-2321
(727) 608-6993
Mailing address
1801 9TH AVE S, SAINT PETERSBURG, FL 33712-2305
(727) 608-6993
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
5201577
FL
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
5201577
FL
Other
Enumeration date
09/22/2021
Last updated
10/04/2021
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