Provider Demographics
NPI:1710379896
Name:RIVERO, ALEJANDRA PATRICIA (COTA)
Entity Type:Individual
Prefix:MRS
First Name:ALEJANDRA
Middle Name:PATRICIA
Last Name:RIVERO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9912 NW 47TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-4706
Mailing Address - Country:US
Mailing Address - Phone:954-303-1485
Mailing Address - Fax:
Practice Address - Street 1:1955 N FEDERAL HWY UNIT 253
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1036
Practice Address - Country:US
Practice Address - Phone:954-580-2520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA14090224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant