Provider Demographics
NPI:1275853046
Name:RIVERO DIAGNOSTIC CENTER INC
Entity Type:Organization
Organization Name:RIVERO DIAGNOSTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OSNAY
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:768-281-7656
Mailing Address - Street 1:7050 NW 4TH ST
Mailing Address - Street 2:202
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2247
Mailing Address - Country:US
Mailing Address - Phone:954-791-9729
Mailing Address - Fax:954-791-9724
Practice Address - Street 1:7050 NW 4TH ST
Practice Address - Street 2:202
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2247
Practice Address - Country:US
Practice Address - Phone:954-791-9729
Practice Address - Fax:954-791-9724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC8721293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory