Individual ProviderAndy Medina RiveroBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address1801 SW 19th St, Miami, FL 33145-2715(786) 354-8790PECOS EnrollmentBased on the most recent information from CMS, provider Andy Medina Rivero does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1114767472Provider TypeIndividualFull NameMedina Rivero, AndyGenderMaleSole ProprietorYesEnumeration Date5/24/2024Last Updated5/24/2024Contact InformationPractice LocationPractice Address1801 SW 19th St, Miami, FL 33145-2715Phone(786) 354-8790FaxUnlisted FaxMailing LocationMailing Address1801 SW 19th St, Miami, FL 33145-2715Phone(786) 354-8790FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer