Provider Demographics
NPI:1891595864
Name:ALVARADO RIVERA, JESSICA MARIE (LMT (MMP))
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIE
Last Name:ALVARADO RIVERA
Suffix:
Gender:
Credentials:LMT (MMP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2687 NE 145TH AVENUE RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34488
Mailing Address - Country:US
Mailing Address - Phone:939-383-0599
Mailing Address - Fax:
Practice Address - Street 1:2687 NE 145TH AVENUE RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34488
Practice Address - Country:US
Practice Address - Phone:939-383-0599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA101559225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty