Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | ME109841 | FL |
NPI | 1316139959 |
---|---|
Provider Name | Dr. Miguel A Rivera |
First Address | Melbourne, FL 32941-1373 |
Second Address | Vero Beach, FL 32960-2533 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2007 |
Last Update Date | 10/11/2014 |