Provider Demographics
NPI:1306162433
Name:RIVO, MARC L (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:L
Last Name:RIVO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4566 PRAIRIE AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3005
Mailing Address - Country:US
Mailing Address - Phone:305-801-6989
Mailing Address - Fax:866-954-9593
Practice Address - Street 1:9064 NW 13TH TER
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2907
Practice Address - Country:US
Practice Address - Phone:305-801-6989
Practice Address - Fax:866-954-9593
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME70493207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine