Individual
DAGOBERTO RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10236 N VALLE DR, TAMPA, FL 33612-6571
(813) 403-2601
Mailing address
10236 N VALLE DR, TAMPA, FL 33612-6571
(813) 403-2601
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN11017601
FL
Other
Enumeration date
01/25/2022
Last updated
01/25/2022
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