Provider Demographics
NPI:1992955942
Name:RIVERO WEISS, ANA MARIA
Entity type:Individual
Prefix:MRS
First Name:ANA
Middle Name:MARIA
Last Name:RIVERO WEISS
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 1:7040 SW 47TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4647
Mailing Address - Country:US
Mailing Address - Phone:308-815-2693
Mailing Address - Fax:305-328-4011
Practice Address - Street 1:7040 SW 47TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4647
Practice Address - Country:US
Practice Address - Phone:308-815-2693
Practice Address - Fax:305-328-4011
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 10005235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000231000Medicaid