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General NPI Number Information
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NPI Number | 1194350678
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Entity Type | Individual
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Provider Name | ILIENIS PEREZ-RIOS PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/05/2020
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 122 KENT PLACE
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City | ALCOA
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State | TN
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Zip | 37701
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Country | US
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Telephone | 865-637-8812
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Fax | 865-342-4678
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Provider Business Mailing Address
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Address Line | 1450 DOWELL SPRINGS BLVD SUITE 300
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City | KNOXVILLE
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State | TN
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Zip | 37909
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Country | US
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Telephone | 865-637-8812
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Fax | 865-637-8865
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9112956
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4101
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License Number State | TN
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