Individual
LAUREN RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
210 RINEHART RD, LAKE MARY, FL 32746-2514
(321) 843-2100
Mailing address
210 RINEHART RD, LAKE MARY, FL 32746-2514
(321) 843-2100
(321) 842-3498
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9109016
FL
363AM0700X
Medical Physician Assistant
Primary
PA109016
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111348600
—
FL
Enumeration date
10/14/2015
Last updated
12/28/2022
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