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General NPI Number Information
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NPI Number | 1598921637
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Entity Type | Organization
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Legal Business Name | RENE DE LOS RIOS MD PA
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Dates
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Enumeration Date | 07/29/2008
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Last Update Date | 02/17/2009
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Provider Practice Location Address
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Address Line | 2732 NW 4TH TER
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City | MIAMI
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State | FL
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Zip | 33125-4341
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Country | US
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Telephone | 305-541-8919
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Fax | 305-642-5548
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Provider Business Mailing Address
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Address Line | PO BOX 350476
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City | MIAMI
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State | FL
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Zip | 33135-0476
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Country | US
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Telephone | 305-541-8919
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Fax | 305-642-5548
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Authorized Official
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Title or Position | PRESIDENT
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Name | RENE DE LOS RIOS
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Credential | MD PA
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Telephone | 305-541-8919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State | FL
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