Active NPI
Iliamaris Rivera Walter, LMFT
- Marriage & Family Therapist
- Davie, FL
National Provider Identifier
1295036929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MT 2676
- Practice address
- 3325 S University Dr
Suite 209
Davie, FL 33328-2006 - Phone
- (954) 649-6014
- NPI assigned
- Nov 11, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MF000604 | PA | |
| Marriage & Family Therapist | 106H00000X | MT 2676 | FL | Primary |
Addresses
Primary practice location
3325 S University Dr
Suite 209
Davie, FL 33328-2006
Mailing address
3325 S University Dr
Suite 209
Davie, FL 33328-2006
Phone (954) 649-6014
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT 2676 | FL | MD | Marriage & Family Therapist |
| MF000604 | PA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365638400000",
"number": "1295036929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3325 S UNIVERSITY DR",
"address_2": "SUITE 209",
"city": "DAVIE",
"state": "FL",
"postal_code": "333282006",
"telephone_number": "954-649-6014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3325 S UNIVERSITY DR",
"address_2": "SUITE 209",
"city": "DAVIE",
"state": "FL",
"postal_code": "333282006",
"telephone_number": "954-649-6014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTER",
"first_name": "ILIAMARIS",
"middle_name": "RIVERA",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-11",
"last_updated": "2013-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "PA",
"license": "MF000604",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "MT 2676",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.