Provider Demographics
NPI:1407176191
Name:RICE, VIVIAN ANN (AP)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:ANN
Last Name:RICE
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 MATANZAS RD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33967-3477
Mailing Address - Country:US
Mailing Address - Phone:239-267-0474
Mailing Address - Fax:
Practice Address - Street 1:16317 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-5326
Practice Address - Country:US
Practice Address - Phone:239-362-0668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1324171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist