Provider Demographics
NPI:1497459366
Name:RIVERO PEREZ, ALBERTO (APRN)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:
Last Name:RIVERO PEREZ
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4604 SOUTHERN PKWY APT B13
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40214-6608
Mailing Address - Country:US
Mailing Address - Phone:502-631-8569
Mailing Address - Fax:
Practice Address - Street 1:4604 SOUTHERN PKWY APT B13
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40214-6608
Practice Address - Country:US
Practice Address - Phone:502-631-8569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4000419363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care