Basic Information
| Provider Information | |||||||||
| NPI: | 1811167505 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DELTORO RIVERA | ||||||||
| FirstName: | ELIUD | ||||||||
| MiddleName: | ARNALDO | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12171 SW 268TH ST | ||||||||
| Address2: | |||||||||
| City: | HOMESTEAD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330328001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052780200 | ||||||||
| FaxNumber: | 7864304111 | ||||||||
| Practice Location | |||||||||
| Address1: | 2791 LAKE ALFRED RD | ||||||||
| Address2: | |||||||||
| City: | WINTER HAVEN | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338811432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8632914590 | ||||||||
| FaxNumber: | 8635086503 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2008 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 17039 | PR | N | Hospitals | General Acute Care Hospital | 208D00000X | ACN776 | FL | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.