NPI 1407273410

Miguel Rivera, MD

Organisation Non-Pharmacy Dispensing Site Fort Myers, FL

Practice location

Address: 8595 College Pkwy STE 110, Fort Myers, FL 33919-5194
Phone: (239) 489-2290
Mailing address: 2295 NW Corporate Blvd STE 245, Boca Raton, FL 33431-7323

Authorised official

Name: Miguel Rivera
Title: Physician
Phone: (239) 489-2290

Registered specialties

Non-Pharmacy Dispensing Site Primary

Suppliers Taxonomy 332900000X Licence ME109841 (FL)

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Registry record

NPI: 1407273410
Entity type: Organization
NPI issued: 27 Mar 2014
Record last updated: 27 Mar 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.