Provider Demographics
NPI:1962189167
Name:BOSCANA RIVERA, CHERLI MAR (BATCHELOR'S DEGREE)
Entity type:Individual
Prefix:
First Name:CHERLI
Middle Name:MAR
Last Name:BOSCANA RIVERA
Suffix:
Gender:F
Credentials:BATCHELOR'S DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 ZINNIA DR
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-5056
Mailing Address - Country:US
Mailing Address - Phone:787-585-2281
Mailing Address - Fax:
Practice Address - Street 1:2639 WRS 434
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779
Practice Address - Country:US
Practice Address - Phone:321-972-8326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI51682355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty