Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251N0400X | Physical Therapist - Neurology | PT 3746 | FL |
Y | 2251P0200X | Physical Therapist - Pediatrics | PT 3746 | FL |
NPI | 1538267794 |
---|---|
Provider Name | Mrs. Hilda Angelica Rivera-Mejias |
First Address | Orlando, FL 32817-2041 |
Second Address | Orlando, FL 32817-2041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 23/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000030871 | CMS KIDS (01) | FL |
882116000 | (05) | FL |
882116096 | MED WAIVER (01) | FL |