Healthcare Provider Details

I. General information

NPI: 1891679239
Provider Name (Legal Business Name): GERALD RIJO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8075 SW 107TH AVE APT 115
MIAMI FL
33173-4885
US

IV. Provider business mailing address

8075 SW 107TH AVE APT 115
MIAMI FL
33173-4885
US

V. Phone/Fax

Practice location:
  • Phone: 646-644-7543
  • Fax:
Mailing address:
  • Phone: 646-644-7543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License NumberR200280872970
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberDJ00PM
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: