Provider Demographics
NPI:1619487766
Name:RIVERO, EUDI VIRGINIA
Entity Type:Individual
Prefix:MRS
First Name:EUDI
Middle Name:VIRGINIA
Last Name:RIVERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3019 SENNA CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-2508
Mailing Address - Country:US
Mailing Address - Phone:407-533-2449
Mailing Address - Fax:
Practice Address - Street 1:3019 SENNA CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-2508
Practice Address - Country:US
Practice Address - Phone:407-533-2449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-03
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician