Rivera, Susan D

Rivera, Susan D is an individual health care provider with primary practice located at 703 Virginia St , Dunedin FL 34698-6615. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Rivera, Susan D can be contacted via phone (727) 734-4000.

Contact Information

Primary practice address
703 Virginia St Dunedin FL 34698-6615
Phone: (727) 734-4000
Fax: (727) 738-5037
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X ARNP9415507 Florida

Profile Details

NPI number 1114918786
LBN Legal business name Rivera, Susan D
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Jul 19th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114918786 NPPES
Indiana Other CJ8803 GROUP RR MEDICARE
Indiana MEDICAID 016093400 GROUP RR MEDICARE
Indiana Other P00146163 GROUP RR MEDICARE
Indiana Other 000000111033 GROUP RR MEDICARE
Indiana Other 000000368986 GROUP RR MEDICARE
Indiana Other 02PZH GROUP RR MEDICARE
Indiana MEDICAID 200471680 GROUP RR MEDICARE

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