| Doctor Name: | SHELAGH MARIE RIVERA |
| NPI Number: | 1174573083 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | ARNP9195792 |
| Business Practice Address: | 2900 Veterans Way Viera, FL - 329408007 |
| Business Phone Number: | 3216373788 |
| Business Fax Number: | 3216373648 |
| Mailing Address: | 2900 Veterans Way, VIERA |
| State: | FL |
| Postal Code: | 32940 |
| Phone Number: | 3216373553 |
| Fax Number: | |
| NPI Enumeration Date: | 05/11/2006 |
| NPI Last Update Date: | 03/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | ARNP9195792 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |