DR. AGUSTIN RIVERA (NPI# 1508226101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508226101 |
| Entity Type | Individual |
| Full Name | DR. AGUSTIN RIVERA |
| Credential | M.D; MC; CLERGY |
| Practice Address |
115 E Lancaster Rd Orlando FL 32809-6689 |
| Mailing Address |
17906 Woodcrest Way Clermont FL 34714-5906 |
| Practice Telephone | 8635829899 |
| Mailing Telephone | 8634209899 |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2019-04-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
PHM 1453 | FL | Behavioral Health & Social Service Providers |
| N | 101YP1600X |
Counselor Specialization: Pastoral |
1702-002 | FL | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 557 | PR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | PROFESSIONAL CERTIFICATE IN COUNSELING ADDICTIVE DISORDERS AND M | P852 NAADA | 01 |
| FL | QUALIFIED SUPERVISOR TRAINING | COURSE 20-32231 | 01 |
| CA | SEXUAL ASSAULT FORENSIC EXAMINER TRAINING | CEP 15893 | 01 |
| FL | DIPLOMATE AMERICAN BOARD OF SEXOLOGY | 2543 | 01 |
| FL | CHILDREN'S FUNCTIONAL ASSESMENT RATING SCALE | 802042738 | 01 |
| PR | TRAUMATOLOGY | 1001A-1005 | 01 |
| FL | FUNCTIONAL ASSESSMENT RATING SCALE | 805036272 | 01 |
| FL | MENTAL HEALTH COUNSELOR | PHM 1453 | 01 |
| PR | MEDICAL DOCTOR | XXXX | 01 |
| PR | MARRIAGE AND FAMILY COUNSELING | MFT 557 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 115 Lake Davenport Blvd Ste C, Davenport, FL 338979405 | 8634209899 |
| Street Address |
115 E LANCASTER RD |
| City | ORLANDO |
| State | FL |
| Zip Code | 32809-6689 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215138433 | Yves Macena | Chiropractor | 115 E Lancaster Rd, Ste. B, Orlando, FL 32809-6689 | 2007-05-29 |
| 1689208274 | Derick J. Velazquez-lucena | General Practice | 115 E Lancaster Rd, Orlando, FL 32809-6689 | 2020-02-24 |
| 1285296798 | Lake Nona Medical Services | General Practice | 115 E Lancaster Rd, Orlando, FL 32809-6689 | 2019-07-03 |
| 1760966915 | Nadine D. Massillon | Nurse Practitioner | 115 E Lancaster Rd, Orlando, FL 32809-6689 | 2018-09-23 |
| 1609393610 | Natalia Ivelisse Rivera-smith | Clinical Ethicist | 115 E Lancaster Rd, Orlando, FL 32809-6689 | 2017-08-29 |
| 1740630946 | Skills 4 You Florida, LLC | Counselor | 115 E Lancaster Rd, Orlando, FL 32809 | 2016-06-17 |
| 1548616378 | Catherine M Arevalo | General Practice | 115 E Lancaster Rd, Orlando, FL 32809-6689 | 2016-05-11 |
| 1104110386 | Adalberto Aguilera | General Practice | 115 E Lancaster Rd, Orlando, FL 32809-6689 | 2011-06-05 |
| 1215108345 | Family Physicians of Winter Park Pa | Family Medicine | 115 E Lancaster Rd, Suite A, Orlando, FL 32809-6689 | 2008-03-17 |
| 1710185632 | First Care Chiropractic & Family Practice Center Inc | Chiropractor | 115 E Lancaster Rd, Orlando, FL 32809-6689 | 2007-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922634765 | Junie Jean-philippe | Chiropractor | 7130 S Orange Blossom Trail Suite 148, Orlando, FL 32809 | 2020-03-12 |
| 1073030276 | Amanda Wiegert | Counselor | 6000 Lake Ellenor Drive, Orlando, FL 32809 | 2017-08-28 |
| 1780114330 | Fanny Vivas | Counselor | 8000 South Orange Avenue, Suite 111, Orlando, FL 32809 | 2017-06-15 |
| 1588101356 | Coassist Pharmacy, LLC | Pharmacy | 2400 Sand Lake Road, Suite 200, Orlando, FL 32809 | 2017-01-31 |
| 1306203872 | Greidis Villalobos | Counselor | 5957 Estella Way, Orlando, FL 32809 | 2016-01-28 |
| 1891113809 | Orville Mario Morgan | Genetic Counselor, MS | 1220 Evangeline Ave., Orlando, FL 32809 | 2014-04-07 |
| 1669727699 | Hispanic Family Counseling Inc | Social Worker | 6900 S Orange Blossom Trl Ste 402, Orlando, FL 32809 | 2012-07-16 |
| 1548529118 | Laurie Lowe Forbes | Pharmacist | 530 Sunport Lane, Orlando, FL 32809 | 2012-05-16 |
| 1972886307 | Viet H Nguyen | Pharmacist | 7003 Presidents Drive Suite 250, Orlando, FL 32809 | 2011-09-22 |
| 1497042774 | Calren S Wang | Physical Therapy Assistant | 1718 Colleen Dr, Belle Isle, FL 32809 | 2011-07-07 |
| Find all providers in zip 32809 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457161 | Jenna Grace Mallek Campos | Counselor | 13626 Phoenix Dr, Orlando, FL 32828-9338 | 2020-11-07 |
| 1295336089 | Resilience Behavioral Health LLC | Counselor | 3211 Calumet Dr, Orlando, FL 32810-2023 | 2020-11-06 |
| 1972103992 | Nadine Ferguson | Counselor | 5932 Folkstone Ln, Orlando, FL 32822-9417 | 2020-10-28 |
| 1386242592 | Orialis Sosa | Counselor | 1613 Park Lake St, Orlando, FL 32803-4154 | 2020-10-12 |
| 1710584057 | Megan E Hunt | Counselor | 1701 Park Center Dr Ste 202, Orlando, FL 32835-6235 | 2020-10-08 |
| 1134726094 | Jeffrey Harris | Counselor | 2568 Woodgate Blvd Apt 203, Orlando, FL 32822-5881 | 2020-10-05 |
| 1568069540 | Ask Schellie Consulting, LLC | Counselor | 2036 36th St, Orlando, FL 32839-8810 | 2020-10-03 |
| 1992319883 | Taleasha Lintayvia Washington | Counselor | 2012 Cabo San Lucas Dr Apt 208, Orlando, FL 32839-8435 | 2020-09-08 |
| 1053925297 | Morgan Mckee | Counselor | 1510 Lake Baldwin Ln Apt B, Orlando, FL 32814-6676 | 2020-09-04 |
| 1104437854 | Eliana Rina Gershon | Counselor | 6203 Steach Dr, Orlando, FL 32808-5436 | 2020-08-14 |
| Find all providers in ORLANDO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.