Provider Demographics
NPI:1982944666
Name:RIVES, STEVEN NATHAN (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:NATHAN
Last Name:RIVES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11924 SHELDON RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-3643
Mailing Address - Country:US
Mailing Address - Phone:813-926-2177
Mailing Address - Fax:813-926-7489
Practice Address - Street 1:11924 SHELDON RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-3643
Practice Address - Country:US
Practice Address - Phone:813-926-2177
Practice Address - Fax:813-926-7489
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-18
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020574207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR215395795Medicaid