Provider Demographics
NPI:1831952159
Name:HERNANDEZ RIVERA, MILARIS TAMAIRY (DC)
Entity type:Individual
Prefix:MS
First Name:MILARIS
Middle Name:TAMAIRY
Last Name:HERNANDEZ RIVERA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5038 BROADSTONE RESERVE CIR APT 238
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-0211
Mailing Address - Country:US
Mailing Address - Phone:787-246-3669
Mailing Address - Fax:
Practice Address - Street 1:877 S ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-6522
Practice Address - Country:US
Practice Address - Phone:407-889-3223
Practice Address - Fax:407-889-7263
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14923111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor