Provider Demographics
NPI:1811193949
Name:RIVERO, ARMANDO J (APRN)
Entity Type:Individual
Prefix:
First Name:ARMANDO
Middle Name:J
Last Name:RIVERO
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15974 SW 151ST TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-5740
Mailing Address - Country:US
Mailing Address - Phone:786-306-7166
Mailing Address - Fax:
Practice Address - Street 1:15974 SW 151ST TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-5740
Practice Address - Country:US
Practice Address - Phone:786-306-7166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL05-179246ZS0410X
FL11003868363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05-179OtherCERTIFIED SURGICAL ASSIST