Provider Demographics
NPI:1346823630
Name:RIVERO, WILLIAM (BCABA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:RIVERO
Suffix:
Gender:
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3661 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-8218
Mailing Address - Country:US
Mailing Address - Phone:239-245-8761
Mailing Address - Fax:239-689-8694
Practice Address - Street 1:3669 SW 2ND AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2856
Practice Address - Country:US
Practice Address - Phone:352-554-6164
Practice Address - Fax:352-240-6876
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FL0-25-15823106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician