Provider Demographics
NPI:1730834425
Name:RIVAS, KAYLA (CPT)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:RIVAS
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 MACDONALD AVE LOT 27
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-5878
Mailing Address - Country:US
Mailing Address - Phone:305-900-0123
Mailing Address - Fax:
Practice Address - Street 1:5300 MACDONALD AVE LOT 27
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-5878
Practice Address - Country:US
Practice Address - Phone:305-900-0123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26343-164-400-4583246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy