Individual
MR. ANGEL M. RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
922 N KROME AVE, HOMESTEAD, FL 33030-4409
(786) 382-3507
(786) 504-8070
Mailing address
922 N KROME AVE, HOMESTEAD, FL 33030-4409
(786) 504-8070
(786) 504-8073
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
SW4114
FL
1041C0700X
Clinical Social Worker
Primary
SW 4114
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011062900
—
FL
01
—
101YM0800X
TAXONOMY
FL
Enumeration date
06/30/2006
Last updated
09/06/2016
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