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General NPI Number Information
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NPI Number | 1306127139
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Entity Type | Individual
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Provider Name | NICHOLAS JAMES RIOS PSY. D.
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Gender | Male
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Dates
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Enumeration Date | 09/07/2011
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Last Update Date | 08/30/2018
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Provider Practice Location Address
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Address Line | 8785 SW 165TH AVE STE 103
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City | MIAMI
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State | FL
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Zip | 33193
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Country | US
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Telephone | 786-206-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 18003 SW 93RD AVE
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City | PALMETTO BAY
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State | FL
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Zip | 33157-5740
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Country | US
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Telephone | 602-821-6063
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Fax | 501-992-0138
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 13-22P
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY9773
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY9773
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License Number State | FL
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