Provider Demographics
NPI:1205588399
Name:RIVERA, EVA ISABEL
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:ISABEL
Last Name:RIVERA
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 1:1100 S MIAMI AVE APT 1211
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-4164
Mailing Address - Country:US
Mailing Address - Phone:512-800-3588
Mailing Address - Fax:
Practice Address - Street 1:999 SW 1ST AVE APT 1606
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3441
Practice Address - Country:US
Practice Address - Phone:512-800-3588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-20
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health