Provider Demographics
NPI:1871223248
Name:RIVERA NIEVES, MARIELA CAROLINA (DC)
Entity type:Individual
Prefix:DR
First Name:MARIELA
Middle Name:CAROLINA
Last Name:RIVERA NIEVES
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 1:4110 PLANTATION COVE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-3532
Mailing Address - Country:US
Mailing Address - Phone:787-224-1679
Mailing Address - Fax:
Practice Address - Street 1:1320 S ORLANDO AVE STE 3
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-5556
Practice Address - Country:US
Practice Address - Phone:407-504-0117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14037111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor