Provider Demographics
NPI:1194001321
Name:ONELIO E. RIERA, MD-PA
Entity Type:Organization
Organization Name:ONELIO E. RIERA, MD-PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ONELIO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-984-4150
Mailing Address - Street 1:4516 NW 114TH AVE
Mailing Address - Street 2:APT 2005
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4801
Mailing Address - Country:US
Mailing Address - Phone:305-823-3312
Mailing Address - Fax:
Practice Address - Street 1:8746 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:MAIMI
Practice Address - State:FL
Practice Address - Zip Code:33165
Practice Address - Country:US
Practice Address - Phone:305-229-6900
Practice Address - Fax:305-226-9997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-02
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME109186207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFN508ZMedicare PIN