| Juan I Rivera | |
|
315 E Olympia Ave 111 Punta Gorda FL 33950-3833 | |
| (941) 639-1640 | |
| (941) 637-9808 |
| Full Name | Juan I Rivera |
|---|---|
| Speciality | Family Medicine |
| Location | 315 E Olympia Ave, Punta Gorda, Florida |
| Authorized Official Name and Position | Juan I Rivera (OWNER) |
| Authorized Official Contact | 9416391640 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Juan I Rivera 315 E Olympia Ave # 111 Punta Gorda FL 33950-3833 Ph: (941) 639-1640 | Juan I Rivera 315 E Olympia Ave 111 Punta Gorda FL 33950-3833 Ph: (941) 639-1640 |
| NPI Number | 1396935037 |
|---|---|
| Provider Enumeration Date | 07/30/2007 |
| Last Update Date | 01/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396935037 | NPI | - | NPPES |
| 072052600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME050857 (Florida) | Primary |
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