Individual
MR. JOSE RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
3800 CENTRAL AVE, ST PETERSBURG, FL 33711-1237
(727) 327-7656
(727) 322-2110
Mailing address
PO BOX 10970, ST PETERSBURG, FL 33733-0970
(727) 327-7656
(727) 322-2110
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5227063
FL
Other
Enumeration date
10/27/2016
Last updated
11/14/2016
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