Active NPI
Kimberly Ledesma Rivera
- Audiologist
- Melbourne, FL
National Provider Identifier
1720764111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AY2736
- Practice address
- 2900 Veterans Way # 126
Melbourne, FL 32940-8007 - Phone
- (321) 637-3788
- NPI assigned
- Jun 22, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AY2736 | FL | Primary |
Addresses
Primary practice location
2900 Veterans Way # 126
Melbourne, FL 32940-8007
Mailing address
2900 Veterans Way
Melbourne, FL 32940-8007
Phone (321) 637-3788
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 |
|---|---|---|---|
| AY2736 | FL | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687392000000",
"number": "1720764111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 VETERANS WAY",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329408007",
"telephone_number": "321-637-3788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 VETERANS WAY # 126",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329408007",
"telephone_number": "321-637-3788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "KIMBERLY",
"middle_name": "LEDESMA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-22",
"last_updated": "2023-06-22",
"certification_date": "2023-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "FL",
"license": "AY2736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.