Provider Demographics
NPI:1528712148
Name:RIVERA, CASSANDRA (APRN)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 SW 22ND PL
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-7765
Mailing Address - Country:US
Mailing Address - Phone:352-732-5042
Mailing Address - Fax:352-732-6031
Practice Address - Street 1:2120 SW 22ND PL
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-7765
Practice Address - Country:US
Practice Address - Phone:352-732-5042
Practice Address - Fax:352-732-6031
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-11
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11018079363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily