Provider Demographics
NPI:1275230674
Name:RIVADENEIRA, ANELIZE (APRN)
Entity type:Individual
Prefix:
First Name:ANELIZE
Middle Name:
Last Name:RIVADENEIRA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ANELIZE
Other - Middle Name:
Other - Last Name:WESSLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34230-1000
Mailing Address - Country:US
Mailing Address - Phone:941-366-0134
Mailing Address - Fax:941-404-1760
Practice Address - Street 1:2105 N NEBRASKA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-2558
Practice Address - Country:US
Practice Address - Phone:813-769-7207
Practice Address - Fax:844-722-0028
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11024470363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology