Healthcare Provider Details

I. General information

NPI: 1922548346
Provider Name (Legal Business Name): FERNANDO DANIEL RIOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: FERNANDO D RIOS MD

II. Dates (important events)

Enumeration Date: 03/04/2017
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5320 PROVIDENCE RD STE 301
VIRGINIA BEACH VA
23464-4122
US

IV. Provider business mailing address

5320 PROVIDENCE RD STE 301
VIRGINIA BEACH VA
23464-4122
US

V. Phone/Fax

Practice location:
  • Phone: 757-413-7600
  • Fax: 757-222-0621
Mailing address:
  • Phone: 757-413-7600
  • Fax: 757-222-0621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number31101
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101285111
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: