Individual
ANGEL LUIS RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
216 BROADWAY, KISSIMMEE, FL 34741-5768
(407) 910-4040
Mailing address
3772 EAGLE ISLE CIR, KISSIMMEE, FL 34746-1907
(321) 333-2573
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME121469
FL
Other
Enumeration date
01/24/2023
Last updated
03/27/2023
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