Provider Demographics
NPI:1083450621
Name:RIVERON ALVAREZ, NURIS
Entity type:Individual
Prefix:
First Name:NURIS
Middle Name:
Last Name:RIVERON ALVAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 N ARMENIA AVE APT 2706
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7361
Mailing Address - Country:US
Mailing Address - Phone:551-306-8640
Mailing Address - Fax:
Practice Address - Street 1:10200 N ARMENIA AVE APT 2706
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7361
Practice Address - Country:US
Practice Address - Phone:551-306-8640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24-353076106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician