Provider Demographics
NPI:1932566825
Name:RIVERA, TONYA
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:
Other - Last Name:RIVERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BACHELORS
Mailing Address - Street 1:146 GRAND JUNCTION BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-1253
Mailing Address - Country:US
Mailing Address - Phone:407-209-6682
Mailing Address - Fax:
Practice Address - Street 1:750 S ORANGE BLOSSOM TRL
Practice Address - Street 2:261
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-3118
Practice Address - Country:US
Practice Address - Phone:407-270-6685
Practice Address - Fax:407-270-6686
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management