Basic Information
| Provider Information | |||||||||
| NPI: | 1851946412 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VILLAMIZAR RIVERO | ||||||||
| FirstName: | JEANY | ||||||||
| MiddleName: | PAOLA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1611 NW 12TH AVE # 600D | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331361096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055855215 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1611 NW 12TH AVE # 600D | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331361096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055855215 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2019 | ||||||||
| LastUpdateDate: | 06/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | TRN29868 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.