| Doctor Name: | MR. RENE YAMIL RIVERA |
| NPI Number: | 1063828895 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.S. |
| License Number: | IMH12264 |
| Business Practice Address: | 2001 W Blue Heron Blvd Riviera Beach, FL - 334045003 |
| Business Phone Number: | 5618843500 |
| Business Fax Number: | 5618443577 |
| Mailing Address: | 2001 W Blue Heron Blvd, RIVIERA BEACH |
| State: | FL |
| Postal Code: | 334045003 |
| Phone Number: | 5618843500 |
| Fax Number: | 5618443577 |
| NPI Enumeration Date: | 07/01/2014 |
| NPI Last Update Date: | 07/01/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | IMH12264 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |