Provider Demographics
NPI:1790712610
Name:RIVERA-GARCIA, LIOVA E (MD)
Entity Type:Individual
Prefix:
First Name:LIOVA
Middle Name:E
Last Name:RIVERA-GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 N RANDALL AVE
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-1122
Mailing Address - Country:US
Mailing Address - Phone:608-758-7215
Mailing Address - Fax:608-758-3216
Practice Address - Street 1:1999 HIGHWAY 51 S
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:TN
Practice Address - Zip Code:38019-3630
Practice Address - Country:US
Practice Address - Phone:901-476-4457
Practice Address - Fax:901-475-4389
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40650207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4134188OtherBLUE CROSS BLUE SHIELD
TN626001636OtherUSA MANAGED CARE
TN626001636OtherBAPTIST HEALTH SERVICES G
TN10024068OtherUAHC
TN188302OtherUNISON
TN37949OtherTLC
TN626001636OtherUNITED HEALTHCARE
TN3337548Medicaid
TN4134188OtherBLUE CROSS BLUE SHIELD
I50882Medicare UPIN