Provider Demographics
NPI:1689916421
Name:RIVERA, NECHNAIRA (COTA)
Entity type:Individual
Prefix:
First Name:NECHNAIRA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 LINCOLN PKWY
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-7847
Mailing Address - Country:US
Mailing Address - Phone:407-607-9415
Mailing Address - Fax:
Practice Address - Street 1:6702 DILLON DR
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-3107
Practice Address - Country:US
Practice Address - Phone:954-529-9208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-19
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12771224Z00000X
TX218553224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant