Provider Demographics
NPI:1447031414
Name:RIVERA, MARIA ELENA (DC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ELENA
Last Name:RIVERA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5044 BROADSTONE RESERVE CIR APT 330
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-0228
Mailing Address - Country:US
Mailing Address - Phone:787-397-0550
Mailing Address - Fax:
Practice Address - Street 1:629 N FERN CREEK AVE STE B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4854
Practice Address - Country:US
Practice Address - Phone:786-325-5741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14677111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor