Provider Demographics
NPI:1437841533
Name:RIVERON, ALBERTO AGUSTIN (MD)
Entity type:Individual
Prefix:
First Name:ALBERTO
Middle Name:AGUSTIN
Last Name:RIVERON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10551 W BROWARD BLVD APT 111
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2129
Mailing Address - Country:US
Mailing Address - Phone:561-797-3154
Mailing Address - Fax:
Practice Address - Street 1:8251 W ROWARD BLVD
Practice Address - Street 2:SUITE 200-208
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324
Practice Address - Country:US
Practice Address - Phone:954-334-3131
Practice Address - Fax:954-334-3132
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23924208D00000X
FLACN1640208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice