Provider Demographics
NPI:1699525808
Name:BV RIVERVIEW, PLLC
Entity type:Organization
Organization Name:BV RIVERVIEW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SENIOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-536-7766
Mailing Address - Street 1:10555 BLOOMINGDALE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-4455
Mailing Address - Country:US
Mailing Address - Phone:813-568-1118
Mailing Address - Fax:813-302-7500
Practice Address - Street 1:10555 BLOOMINGDALE RIDGE DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-4455
Practice Address - Country:US
Practice Address - Phone:813-568-1118
Practice Address - Fax:813-302-7500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty