Provider Demographics
NPI:1871325894
Name:RIVERA COLLET, CESAR JAVIER (APRN)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:JAVIER
Last Name:RIVERA COLLET
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 DADE AVE APT 1125
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4607
Mailing Address - Country:US
Mailing Address - Phone:787-453-9685
Mailing Address - Fax:
Practice Address - Street 1:715 E VINE ST STE 1&2
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4232
Practice Address - Country:US
Practice Address - Phone:407-930-1112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11033278363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily