Provider Demographics
NPI:1629580584
Name:RIVERA-REYES, SELYS YALEXI (BA)
Entity Type:Individual
Prefix:
First Name:SELYS
Middle Name:YALEXI
Last Name:RIVERA-REYES
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:SELYS
Other - Middle Name:
Other - Last Name:RIVERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1741 W MARSHALL LAKE DR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-1622
Mailing Address - Country:US
Mailing Address - Phone:774-242-4241
Mailing Address - Fax:
Practice Address - Street 1:6900 S ORANGE BLOSSOM TRL STE 402
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-5734
Practice Address - Country:US
Practice Address - Phone:407-917-0919
Practice Address - Fax:407-917-0919
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty