| Doctor Name: | DR. JOSE EMILIANO RIVAS |
| NPI Number: | 1952588188 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | ME 121469 |
| Business Practice Address: | 9938 Universal Blvd Ste 102 Orlando, FL - 328198705 |
| Business Phone Number: | 4076155844 |
| Business Fax Number: | 4079309232 |
| Mailing Address: | 1113 Lattimore Dr, CLERMONT |
| State: | FL |
| Postal Code: | 347119032 |
| Phone Number: | 9417794870 |
| Fax Number: | |
| NPI Enumeration Date: | 01/30/2008 |
| NPI Last Update Date: | 12/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ME 121469 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |