Provider Demographics
NPI:1770241812
Name:RIVERA, NATALY (PHLEBOTOMIST)
Entity Type:Individual
Prefix:
First Name:NATALY
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BAYVIEW DR APT 1716
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4760
Mailing Address - Country:US
Mailing Address - Phone:786-763-4410
Mailing Address - Fax:
Practice Address - Street 1:100 BAYVIEW DR APT 1716
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4760
Practice Address - Country:US
Practice Address - Phone:786-763-4410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy