Provider Demographics
NPI:1639040124
Name:CLOVER DIAGNOSTIC CENTER, CORP.
Entity type:Organization
Organization Name:CLOVER DIAGNOSTIC CENTER, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARYAN
Authorized Official - Middle Name:RIZI
Authorized Official - Last Name:RIVERO
Authorized Official - Suffix:
Authorized Official - Credentials:MHA, RVT, RDMS
Authorized Official - Phone:561-264-7036
Mailing Address - Street 1:2416 THOMAS CT
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-4660
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2416 THOMAS CT
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-4660
Practice Address - Country:US
Practice Address - Phone:561-264-7036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty