Provider Demographics
NPI:1356045041
Name:RIVEIRA MOSCATO, JUAN DAVID
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:DAVID
Last Name:RIVEIRA MOSCATO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14324 SW 176TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-2614
Mailing Address - Country:US
Mailing Address - Phone:407-924-3986
Mailing Address - Fax:
Practice Address - Street 1:8601 SW 199TH ST
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1935
Practice Address - Country:US
Practice Address - Phone:305-908-2999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-262316225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist