Provider Demographics
NPI:1447070594
Name:RIVEIRO YUKHYMETS, VICTOR
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:RIVEIRO YUKHYMETS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7375 W 3RD CT APT 414
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-5048
Mailing Address - Country:US
Mailing Address - Phone:786-376-1215
Mailing Address - Fax:
Practice Address - Street 1:7375 W 3RD CT APT 414
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-5048
Practice Address - Country:US
Practice Address - Phone:786-376-1215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-380049106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician