Provider Demographics
NPI:1114530599
Name:RIVERO, JANELLE (APRN, CNM)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:
Last Name:RIVERO
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:JANELLE
Other - Middle Name:
Other - Last Name:JANER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:1633 FAIRWAY RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-3270
Mailing Address - Country:US
Mailing Address - Phone:954-850-9238
Mailing Address - Fax:
Practice Address - Street 1:8110 ROYAL PALM BLVD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5795
Practice Address - Country:US
Practice Address - Phone:954-341-8288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNM06554367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife