Rivera Medical Office, LLC

NPI #1689883035 in Carlyle, Illinois

Provider Information

NPI Number: 1689883035
Entity Type: Organization
Organization Name: Rivera Medical Office, LLC
Primary Specialty: Surgery
Enumeration Date: May 22, 2007
Last Updated: May 12, 2008

Practice Location

Address: 1110 MULLIKEN ST
City: Carlyle
State: Illinois
ZIP Code: 62231-1233
Phone: (618) 594-3613

Authorized Official

Name: LISA RIVERA
Title: OFFICE MANAGER
Phone: (618) 594-3613

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X
Pediatrics	208000000X
Surgery	208600000X	Primary

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