Provider Demographics
NPI:1932139391
Name:RIVERA HERNANDEZ, DELIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:DELIA
Middle Name:M
Last Name:RIVERA HERNANDEZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1601 NW 12TH AVE
Mailing Address - Street 2:BOX 016960 M851
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33101-6960
Mailing Address - Country:US
Mailing Address - Phone:305-243-4029
Mailing Address - Fax:305-243-8470
Practice Address - Street 1:1601 NW 12TH AVE
Practice Address - Street 2:BOX 016960 M851
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33101-6960
Practice Address - Country:US
Practice Address - Phone:305-243-4029
Practice Address - Fax:305-243-8470
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2013-01-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME628292080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3720713-00Medicaid
FL18490Medicare UPIN
FL3720713-00Medicaid