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General NPI Number Information
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NPI Number | 1053384479
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Entity Type | Individual
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Provider Name | MIRIAM E. RIOS MOTTA M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | CENTRO INTERNACIONAL DE MERCADEO SUITE 306 CARRETERA 165
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City | GUAYNABO
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State | PR
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Zip | 00968
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Country | US
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Telephone | 787-781-2402
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Fax | 787-781-2464
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Provider Business Mailing Address
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Address Line | PO BOX 19345
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City | SAN JUAN
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State | PR
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Zip | 00910-1345
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Country | US
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Telephone | 787-781-2402
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Fax | 787-781-2464
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 12159
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License Number State | PR
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