Most Relevant Information
Provider Data
| NPI Number: | 1003634916 |
| Provider Name: | LAURA NICOLE RIVAS PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 9119287 |
Most Important Dates
| Enumeration Date: | 09/30/2024 |
| Last Updated: | 09/30/2024 |
Provider Practice Location
950 NW 20TH ST
MIAMI
FL
331274622
Practice Location Phone/Fax
| Phone: | 3052374141 |
| Fax: |
Provider Mailing Location
950 NW 20TH ST
MIAMI
FL
331274622
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |