Healthcare Provider Details

I. General information

NPI: 1356350235
Provider Name (Legal Business Name): GERMINA EMILY RISOS-RIO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 02/22/2025
Certification Date: 02/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2343 HUCKINS CT
JACKSONVILLE FL
32225-1558
US

IV. Provider business mailing address

2343 HUCKINS CT
JACKSONVILLE FL
32225-1558
US

V. Phone/Fax

Practice location:
  • Phone: 904-997-9857
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN2083252
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN2083252
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: