Provider Demographics
NPI:1225667934
Name:RIVERA, ZAMARIS
Entity Type:Individual
Prefix:
First Name:ZAMARIS
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 ESTELLA ROAD
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746
Mailing Address - Country:US
Mailing Address - Phone:787-514-5574
Mailing Address - Fax:
Practice Address - Street 1:12805 PEGASUS DRIVE
Practice Address - Street 2:ROOM 123
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32816
Practice Address - Country:US
Practice Address - Phone:407-823-0171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-04
Last Update Date:2020-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program