Provider Demographics
NPI:1780263244
Name:HERNANDEZ RIVERO, ALIAN
Entity type:Individual
Prefix:
First Name:ALIAN
Middle Name:
Last Name:HERNANDEZ RIVERO
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 1:11351 SW 41ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-4606
Mailing Address - Country:US
Mailing Address - Phone:786-296-7676
Mailing Address - Fax:
Practice Address - Street 1:11351 SW 41ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-4606
Practice Address - Country:US
Practice Address - Phone:786-296-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator