Provider Demographics
NPI:1871388165
Name:RIVERA, KAILA (APRN)
Entity type:Individual
Prefix:
First Name:KAILA
Middle Name:
Last Name:RIVERA
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 1:13031 SUNSHINE VIEW CT
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-9343
Mailing Address - Country:US
Mailing Address - Phone:407-432-0701
Mailing Address - Fax:
Practice Address - Street 1:13031 SUNSHINE VIEW CT
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-9343
Practice Address - Country:US
Practice Address - Phone:407-432-0701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11038771363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner