Provider Demographics
NPI:1548384472
Name:GARCIA-RIVERA, MARIA TERESA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:TERESA
Last Name:GARCIA-RIVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 SW 57TH AVE
Mailing Address - Street 2:SUITE 102-A
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5428
Mailing Address - Country:US
Mailing Address - Phone:305-667-6111
Mailing Address - Fax:305-667-6222
Practice Address - Street 1:7600 SW 57TH AVE
Practice Address - Street 2:SUITE 102-A
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5428
Practice Address - Country:US
Practice Address - Phone:305-667-6111
Practice Address - Fax:305-667-6222
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0055857207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE74929Medicare UPIN