Provider Demographics
NPI:1275703738
Name:RIVERO, PEDRO R
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:R
Last Name:RIVERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 PONCE DE LEON
Mailing Address - Street 2:116
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:305-448-8690
Mailing Address - Fax:305-448-8689
Practice Address - Street 1:1000 PONCE DE LEON BLVD
Practice Address - Street 2:116
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3353
Practice Address - Country:US
Practice Address - Phone:305-448-8690
Practice Address - Fax:305-448-8689
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRH924937Z163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health