Individual provider Active NPI

Angelis Rivero, RN

  • Nurse Practitioner
  • Doral, FL
National Provider Identifier
1457023392
Registry record updated Dec 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11042193 Issued in FL
Practice address
8175 NW 12TH St Ste 306
Doral, FL 33126-1828
Phone
(305) 575-3800
Fax
(305) 470-5846
NPI assigned
Sep 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11042193 FL Primary

Addresses

Primary practice location

8175 NW 12TH St Ste 306
Doral, FL 33126-1828

Mailing address

8175 NW 12TH St Ste 306
Doral, FL 33126-1828
Phone (305) 575-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260430002702 FL Practitioner - Nurse Practitioner 9931676558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10451 NW 117TH Ave
Suite 200
Medley, FL 33178-1138

PO Box
Atlanta, GA 30384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
11042193FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Oct 5, 2021 Accepting new patients
Florida Department of Health PastSince Oct 5, 2021 Accepting new patients

Locations

8175 NW 12th St
Ste 306
Doral, FL 33126
Phone (786) 845-0173

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766880000000",
    "number": "1457023392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8175 NW 12TH ST STE 306",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261828",
            "telephone_number": "305-575-3800",
            "fax_number": "305-470-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8175 NW 12TH ST STE 306",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261828",
            "telephone_number": "305-575-3800",
            "fax_number": "305-470-5846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERO",
        "first_name": "ANGELIS",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-29",
        "last_updated": "2025-12-28",
        "certification_date": "2025-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11042193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.