Provider Demographics
NPI:1851909311
Name:PALOMINO RIVAS, CYNTHIA MILAGROS (APRN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MILAGROS
Last Name:PALOMINO RIVAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 NW 95TH ST STE 207
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150-2064
Mailing Address - Country:US
Mailing Address - Phone:305-835-7045
Mailing Address - Fax:305-836-2359
Practice Address - Street 1:1190 NW 95TH ST STE 207
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-2064
Practice Address - Country:US
Practice Address - Phone:305-835-7045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2021-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11008237363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily