Jose A Rivera, MANAGING CONTROL CEO

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Practice address

1906 N John Young Pkwy
Kissimmee, FL 34741

Phone

(407) 994-4606

Fax

(888) 338-4430

NPI assigned

Apr 13, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carrousel Health Care Corporation

  • Primary Care Clinic/Center
  • Kissimmee, FL
  • NPI 1730692450
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1114414380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "34741",
            "telephone_number": "407-994-4606",
            "fax_number": "888-338-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "34741",
            "telephone_number": "407-994-4606",
            "fax_number": "888-338-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "JOSE",
        "middle_name": "A",
        "credential": "MANAGING CONTROL CEO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-13",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Rivera, RN
• Jeielys Rivera
• Jennifer Rivera
• Jonathan Rivera
• Jose Rivera
• Jose L, Rivera, PH.D.
• Kimberly Sarai Rivera, LCSW
• Lily Ann Rivera, MA, CAP, LMHC
• Lisamarie Rivera
• Lissette Rivera, RBT

• Primary Care Clinic/Center in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.