Individual
JENISSER RIVAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6900 TAVISTOCK LAKES BLVD STE 400, ORLANDO, FL 32827-7593
(407) 970-0824
Mailing address
7565 SW 152ND AVE APT F112, MIAMI, FL 33193-2385
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA29310
FL
Other
Enumeration date
06/20/2019
Last updated
06/20/2019
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