Provider Demographics
NPI:1285835520
Name:RIVERA, CYNTHIA IVELISSE (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:IVELISSE
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 ALTON RD
Mailing Address - Street 2:LOWENSTEIN BUILDING #131
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2948
Mailing Address - Country:US
Mailing Address - Phone:305-674-2766
Mailing Address - Fax:305-674-2765
Practice Address - Street 1:4300 ALTON RD
Practice Address - Street 2:GREENE PAVILLION SUITE 450
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2948
Practice Address - Country:US
Practice Address - Phone:305-674-2766
Practice Address - Fax:305-674-2765
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99535207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine