Provider Demographics
NPI:1487528493
Name:TIRADO RIVERA, LORRAINE (ATR-P)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:TIRADO RIVERA
Suffix:
Gender:F
Credentials:ATR-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SE 1ST ST APT 3203
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-1459
Mailing Address - Country:US
Mailing Address - Phone:305-645-3254
Mailing Address - Fax:
Practice Address - Street 1:8500 SW 8TH ST STE 258
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4000
Practice Address - Country:US
Practice Address - Phone:305-810-8869
Practice Address - Fax:305-402-6468
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25-389221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist