Most Relevant Information
Provider Data
| NPI Number: | 1003324633 |
| Provider Name: | LUIS RIVERA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/17/2018 |
| Last Updated: | 06/24/2020 |
Provider Practice Location
1140 KYLE WOOD LN
BRANDON
FL
335114850
Practice Location Phone/Fax
| Phone: | 4079157729 |
| Fax: |
Provider Mailing Location
300 INTERNATIONAL PKWY STE 200
LAKE MARY
FL
327465028
Provider Mailing Phone/Fax
| Phone: | 4079157729 |
| Fax: |