Provider Demographics
NPI:1447857123
Name:ROLON-RIVERA, OMAYRA
Entity type:Individual
Prefix:
First Name:OMAYRA
Middle Name:
Last Name:ROLON-RIVERA
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 1:714 CHINOY RD
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-8633
Mailing Address - Country:US
Mailing Address - Phone:407-491-8542
Mailing Address - Fax:844-972-1525
Practice Address - Street 1:714 CHINOY RD
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-8633
Practice Address - Country:US
Practice Address - Phone:407-491-8542
Practice Address - Fax:844-972-1525
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator