RIVIERA PLAZA MEDICAL OFFICE LLC
NPI 1013338144
Clinic/Center - Primary Care in Holly Hill, FL

Active since December 16, 2013
1702 RIDGEWOOD AVE, SUITE I, HOLLY HILL, FL 32117(386) 677-5415(386) 677-1475 Get Directions Write a Review

NPPES record last updated: April 23, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Riviera Plaza Medical Office Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RIVIERA PLAZA MEDICAL OFFICE LLC (NPI 1013338144) is a healthcare organization registered as a primary care in Holly Hill, Florida and active in the NPI registry since December 2013. The organization lists Gloria Helen Mikula, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1013338144
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameRIVIERA PLAZA MEDICAL OFFICE LLC
Location Address1702 RIDGEWOOD AVE, SUITE IHolly Hill, FL 32117-5416
Mailing Address208 N Halifax Ave, Suite1Daytona Beach, FL 32118-4159 · (386) 677-5415 · Fax (386) 677-1475
Fax(386) 677-1475
Organization SubpartNo
Authorized OfficialGloria Helen MikulaMedical Director · (386) 677-5415
Enumeration DateDecember 16, 2013
Last NPPES UpdateApril 23, 2014
NPI 1013338144 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License Licensed in FL · ME47765
1702 RIDGEWOOD AVE, Holly Hill, FL 32117

Other Identifiers 4

Medicaid042193600FL
Medicare UPIND50685FL
OtherHS776AFL · Medicare Ptan
Medicare PIN02936FL

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist
1702 RIDGEWOOD AVE
HOLLY HILL, FL 32117
Pharmacy
1702 RIDGEWOOD AVE, SUITE A - G
HOLLY HILL, FL 32117

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Riviera Plaza Medical Office LLC's NPI number?

The NPI number for Riviera Plaza Medical Office LLC is 1013338144. It was assigned to this organization in the NPPES registry on December 16, 2013.

Where is Riviera Plaza Medical Office LLC located?

Riviera Plaza Medical Office LLC is located at 1702 Ridgewood Ave Suite I, Holly Hill, FL 32117. The listed phone number is (386) 677-5415.

What is Riviera Plaza Medical Office LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Riviera Plaza Medical Office LLC was last updated on April 23, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.