Provider Demographics
NPI:1750093639
Name:RIVERA SILVA, MARIA ISABEL (MS SLP)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ISABEL
Last Name:RIVERA SILVA
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 CHERRY LAUREL DR APT 224
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-8867
Mailing Address - Country:US
Mailing Address - Phone:787-587-8290
Mailing Address - Fax:
Practice Address - Street 1:2450 CHERRY LAUREL DR APT 224
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-8867
Practice Address - Country:US
Practice Address - Phone:787-587-8290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-22
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ10235235Z00000X
FLSA21928235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSZ10235OtherPROVISIONAL LICENSES
FLSZ10235OtherPROVISIONAL LICENSES