Basic Information
Provider Information
NPI: 1588915045
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RIVERO-BARBA
FirstName: AMINA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PSY.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10030 SW 14TH TER
Address2:  
City: MIAMI
State: FL
PostalCode: 331742862
CountryCode: US
TelephoneNumber: 3057518626
FaxNumber:  
Practice Location
Address1: 5200 NE 2ND AVE
Address2:  
City: MIAMI
State: FL
PostalCode: 331372706
CountryCode: US
TelephoneNumber: 3057518626
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/25/2012
LastUpdateDate: 11/05/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103G00000XPY 8539FLY Behavioral Health & Social Service ProvidersClinical Neuropsychologist 

No ID Information.


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