Provider Demographics
NPI:1669073847
Name:RIVERO RAMOS, LINEY (APRN)
Entity type:Individual
Prefix:
First Name:LINEY
Middle Name:
Last Name:RIVERO RAMOS
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 1:6022 WILSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-3432
Mailing Address - Country:US
Mailing Address - Phone:305-783-4470
Mailing Address - Fax:
Practice Address - Street 1:1903 E FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-3713
Practice Address - Country:US
Practice Address - Phone:813-344-1084
Practice Address - Fax:813-803-5444
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11009923363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty