Individual
JAZMIN RIVERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2036 CROSS BREEZE DR, WELLINGTON, FL 33414-8075
(561) 543-2096
Mailing address
2036 CROSS BREEZE DR, WELLINGTON, FL 33414-8075
(561) 543-2096
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9113813
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2020
Last updated
01/13/2021
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