IndividualActive
Andrew Rivera, PTA
NPI 1003621103 · Pediatric Rehabilitation Medicine Physician · Lakeland, FL
Provider details
- NPI number
- 1003621103
- Entity type
- Individual
- Primary specialty
- Pediatric Rehabilitation Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- PTA
- Sex
- Male
- Sole proprietor
- Yes
- License
- 225200000X (FL)
Mailing address
3647 Lazy Lake Dr S
Lakeland, FL 33801-6470
Registry dates
- Enumerated
- 2025-02-07
- Last updated
- 2025-02-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.