Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 11015906 | FL |
NPI | 1023772274 |
---|---|
Provider Name | Emily Rivero |
First Address | Cooper City, FL 33328-4321 |
Second Address | Weston, FL 33331-3625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2021 |
Last Update Date | 25/10/2021 |