Healthcare Provider Details

I. General information

NPI: 1730424987
Provider Name (Legal Business Name): MYLENE GISELA ASMAR-RIOS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2012
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CALLE BARBOSA STE 1
ISABELA PR
00662-2979
US

IV. Provider business mailing address

16219 SW 99TH TER
MIAMI FL
33196-5900
US

V. Phone/Fax

Practice location:
  • Phone: 513-302-8274
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number003055
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: