Provider Demographics
NPI:1861151771
Name:RIVERA, DAYANARA (BS)
Entity type:Individual
Prefix:
First Name:DAYANARA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 NORMANDY DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-7007
Mailing Address - Country:US
Mailing Address - Phone:407-569-9331
Mailing Address - Fax:
Practice Address - Street 1:1132 NORMANDY DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-7007
Practice Address - Country:US
Practice Address - Phone:407-569-9331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator