Provider Demographics
NPI:1427219021
Name:RIVERA, SAULO J (AP)
Entity Type:Individual
Prefix:
First Name:SAULO
Middle Name:J
Last Name:RIVERA
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 ELKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-8167
Mailing Address - Country:US
Mailing Address - Phone:407-383-3831
Mailing Address - Fax:407-277-3616
Practice Address - Street 1:451 ELKWOOD LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-8167
Practice Address - Country:US
Practice Address - Phone:407-383-3831
Practice Address - Fax:407-277-3616
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 1625171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist