Provider Demographics
NPI:1700583648
Name:RIVERA, ROCHELLE VICTORIA
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:VICTORIA
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 1:14874 CABLESHIRE WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-4272
Mailing Address - Country:US
Mailing Address - Phone:407-748-5721
Mailing Address - Fax:
Practice Address - Street 1:2980 PARK POND WAY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7660
Practice Address - Country:US
Practice Address - Phone:407-930-4711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator