Provider Demographics
NPI:1598538332
Name:HERNANDEZ RIVERO, GIANEXIS (ARNP)
Entity Type:Individual
Prefix:
First Name:GIANEXIS
Middle Name:
Last Name:HERNANDEZ RIVERO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 971946
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33197-1946
Mailing Address - Country:US
Mailing Address - Phone:786-477-3425
Mailing Address - Fax:
Practice Address - Street 1:12352 SW 198TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-4953
Practice Address - Country:US
Practice Address - Phone:786-477-3425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11029513363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health