Provider Demographics
NPI:1821702804
Name:RIVERO MARTINEZ, KARINA D
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:D
Last Name:RIVERO MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8611 SW 68TH CT APT 3
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-1137
Mailing Address - Country:US
Mailing Address - Phone:954-670-3754
Mailing Address - Fax:
Practice Address - Street 1:8611 SW 68TH CT APT 3
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156-1137
Practice Address - Country:US
Practice Address - Phone:954-670-3754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician