Provider Demographics
NPI:1609803832
Name:RIVERA SANCHEZ, ALBERTO
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:
Last Name:RIVERA SANCHEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5365 W ATLANTIC AVE STE 504
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8194
Mailing Address - Country:US
Mailing Address - Phone:561-241-9300
Mailing Address - Fax:561-241-9339
Practice Address - Street 1:1170 S SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-1458
Practice Address - Country:US
Practice Address - Phone:407-622-7246
Practice Address - Fax:407-599-7246
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME125319208100000X, 2081P2900X, 208VP0014X
PR15860208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3515860OtherUIA
PR602018OtherMEDICARE Y MUCHO MAS
PR7160060OtherHUMANA HEALTH PLAN
PR7160060OtherHUMANA INSURANCE
PR23320OtherTRIPLE S
PR23320OtherTRIPLE S OPTIMO
PR7160060OtherHUMANA INSURANCE
PR23320OtherTRIPLE S OPTIMO
PR602018OtherMEDICARE Y MUCHO MAS
PR23320OtherTRIPLE S
PR23320OtherTRIPLE S
PR0023320Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER