Healthcare Provider Details

I. General information

NPI: 1912505629
Provider Name (Legal Business Name): MARIELA RIOS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8831 IMMOKALEE RD
NAPLES FL
34120-3914
US

IV. Provider business mailing address

1532 DESOTO BLVD S
NAPLES FL
34117-9467
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 786-319-6537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11009305
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: