Provider Demographics
NPI:1023484581
Name:RIVERA-NAVARRO, TANIA
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:
Last Name:RIVERA-NAVARRO
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 1:8516 NORTHLAKE PKWY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-6918
Mailing Address - Country:US
Mailing Address - Phone:787-448-1345
Mailing Address - Fax:
Practice Address - Street 1:8516 NORTHLAKE PKWY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-6918
Practice Address - Country:US
Practice Address - Phone:787-448-1345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health