Provider Demographics
NPI:1386199685
Name:RIVAS, NABILA
Entity Type:Individual
Prefix:
First Name:NABILA
Middle Name:
Last Name:RIVAS
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 1:2217 CYPRESS ISLAND DR
Mailing Address - Street 2:APT 608
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-5648
Mailing Address - Country:US
Mailing Address - Phone:954-451-4423
Mailing Address - Fax:
Practice Address - Street 1:2217 CYPRESS ISLAND DR
Practice Address - Street 2:APT 608
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-5648
Practice Address - Country:US
Practice Address - Phone:954-451-4423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other