Healthcare Provider Details

I. General information

NPI: 1336125301
Provider Name (Legal Business Name): MARCOS A PARRILLA RIOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE JOSE TOUS SOTO 108
SAN LORENZO PR
00754
US

IV. Provider business mailing address

42 HARBOUR LIGHTS DR PALMAS DEL MAR
HUMACAO PR
00791-6053
US

V. Phone/Fax

Practice location:
  • Phone: 787-736-0252
  • Fax: 787-736-5545
Mailing address:
  • Phone: 787-736-0252
  • Fax: 787-736-5545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number12258
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: