Dr. Raul Javier Vargas Rivera, MD
General Practice in Winter Haven, FL. Individual provider (NPI-1).
NPI number1962098749
StatusActive
Last updated in NPPESSep 13, 2023
Details
- NPI
- 1962098749
- Entity type
- Individual (NPI-1)
- Name
- Dr. Raul Javier Vargas Rivera
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 16, 2020
- Certification date
- Sep 13, 2023
- Last updated
- Sep 13, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - GENERAL PRACTICE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | ACN1361 | FL | Yes |
| 208D00000X | General Practice | MED-PHYS-REG-0002152 | MT | |
| 208D00000X | General Practice | TPME1150 | FL | |
| 363AM0700X | Physician Assistant, Medical | TPPA107 | FL |
Practice location
217 E Central AveWinter Haven, FL 33880-6312
Phone 407-315-3637 · Fax 407-358-3440
Mailing address
Po Box 532Lake Alfred, FL 33850-0532
Phone 407-315-3637 · Fax 407-358-3440
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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