Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | D0067448 | MD |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | ME104101 | FL |
NPI | 1720269681 |
---|---|
Provider Name | Dr. Venus Rebecca Rivera |
First Address | Miami, FL 33173-3570 |
Second Address | Miami, FL 33173-3570 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2007 |
Last Update Date | 12/03/2014 |