Basic Information
| Provider Information | |||||||||
| NPI: | 1609803832 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIVERA SANCHEZ | ||||||||
| FirstName: | ALBERTO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5365 W ATLANTIC AVE STE 504 | ||||||||
| Address2: | |||||||||
| City: | DELRAY BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334848194 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5612419300 | ||||||||
| FaxNumber: | 5612419339 | ||||||||
| Practice Location | |||||||||
| Address1: | 1170 S SEMORAN BLVD | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328071458 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4076227246 | ||||||||
| FaxNumber: | 4075997246 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2006 | ||||||||
| LastUpdateDate: | 02/23/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | ME125319 | FL | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 2081P2900X | ME125319 | FL | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine | 208VP0014X | ME125319 | FL | Y | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 3515860 | 01 | PR | UIA | OTHER | 602018 | 01 | PR | MEDICARE Y MUCHO MAS | OTHER | 7160060 | 01 | PR | HUMANA HEALTH PLAN | OTHER | 7160060 | 01 | PR | HUMANA INSURANCE | OTHER | 23320 | 01 | PR | TRIPLE S | OTHER | 23320 | 01 | PR | TRIPLE S OPTIMO | OTHER |