Provider Demographics
NPI:1477763696
Name:RIVERO, EDUARDO CHRISTOPHER (DC,MPH,PA-C)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:CHRISTOPHER
Last Name:RIVERO
Suffix:
Gender:M
Credentials:DC,MPH,PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8903 GLADES RD
Mailing Address - Street 2:STE A11
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-2006
Mailing Address - Country:US
Mailing Address - Phone:561-482-7575
Mailing Address - Fax:561-482-7724
Practice Address - Street 1:3650 NW 82ND AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6658
Practice Address - Country:US
Practice Address - Phone:305-227-4263
Practice Address - Fax:305-537-7222
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2020-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9102542363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU2852YMedicare ID - Type Unspecified
FLT96026Medicare UPIN