Provider Demographics
NPI:1467192773
Name:ALFONSO RIVERO, ANEIVIS M
Entity Type:Individual
Prefix:
First Name:ANEIVIS
Middle Name:M
Last Name:ALFONSO RIVERO
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 1:10521 SW 166TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-3065
Mailing Address - Country:US
Mailing Address - Phone:239-600-8348
Mailing Address - Fax:
Practice Address - Street 1:10521 SW 166TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-3065
Practice Address - Country:US
Practice Address - Phone:239-600-8348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician