Provider Demographics
NPI:1609393610
Name:RIVERA-SMITH, NATALIA IVELISSE (BA, MASJ, JD)
Entity Type:Individual
Prefix:MISS
First Name:NATALIA
Middle Name:IVELISSE
Last Name:RIVERA-SMITH
Suffix:
Gender:F
Credentials:BA, MASJ, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17906 WOODCREST WAY
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34714-5906
Mailing Address - Country:US
Mailing Address - Phone:787-646-6684
Mailing Address - Fax:787-646-6684
Practice Address - Street 1:115 E LANCASTER RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-6689
Practice Address - Country:US
Practice Address - Phone:863-582-9899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-29
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174V00000XOther Service ProvidersClinical Ethicist