Provider Demographics
NPI:1457924003
Name:RIVERA CORDERO, ROBERTO OSCAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:OSCAR
Last Name:RIVERA CORDERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2344 NW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3249
Mailing Address - Country:US
Mailing Address - Phone:305-649-6090
Mailing Address - Fax:
Practice Address - Street 1:2344 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3249
Practice Address - Country:US
Practice Address - Phone:305-649-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22450261QP2300X
FLACN1381208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care