| NPI | 1255928040 |
|---|---|
| Doing Business As | RIVERSIDE FAMILY & LIFESTYLE MEDICINE |
| Entity Type | Organization |
| Authorized Contact | LUIS BARATA Owner 239-351-2044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2020-12-28 |
| Last Update Date | 2021-01-14 |