Healthcare Provider Details

I. General information

NPI: 1285896787
Provider Name (Legal Business Name): AMARIS ENID RIOS-GERENA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 11/10/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 NE 2ND AVE FL 3
MIAMI FL
33137-2706
US

IV. Provider business mailing address

6400 SHAFER CT STE 700
ROSEMONT IL
60018-4989
US

V. Phone/Fax

Practice location:
  • Phone: 305-762-3883
  • Fax:
Mailing address:
  • Phone: 346-376-1702
  • Fax: 224-532-2780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberME135425
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: