Individual
NATHANIEL B RIEVESCHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1886 S 14TH ST STE 5, FERNANDINA BEACH, FL 32034-4719
(504) 214-2722
Mailing address
12885 SW 1ST LN APT 410, NEWBERRY, FL 32669-3587
(504) 214-2722
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME161961
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2019
Last updated
06/10/2024
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