Provider Demographics
NPI:1881078780
Name:TOSADO RIVERA, MIGUEL ANGEL (MD)
Entity type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:ANGEL
Last Name:TOSADO RIVERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2851 S AVENUE B BLDG 20
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7726
Mailing Address - Country:US
Mailing Address - Phone:928-336-2434
Mailing Address - Fax:928-336-2435
Practice Address - Street 1:2851 S AVENUE B BLDG 20
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7726
Practice Address - Country:US
Practice Address - Phone:928-336-2434
Practice Address - Fax:928-336-2435
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-10
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR29892-R2084P0800X
AZ504182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry