Provider Demographics
NPI:1386340420
Name:RIVERA, CYNTHIA EDITH
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:EDITH
Last Name:RIVERA
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 1:1098 HERMOSA WAY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-7220
Mailing Address - Country:US
Mailing Address - Phone:407-840-0100
Mailing Address - Fax:
Practice Address - Street 1:1098 HERMOSA WAY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-7220
Practice Address - Country:US
Practice Address - Phone:407-840-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist