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General NPI Number Information
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NPI Number | 1720941891
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Entity Type | Individual
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Provider Name | JOHAM GABRIEL RIOS RODRIGUEZ MD
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Gender | Male
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 100 AVE LUIS MUNOZ MARIN
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City | CAGUAS
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State | PR
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Zip | 00725-6184
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Country | US
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Telephone | 787-930-2402
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Fax |
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Provider Business Mailing Address
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Address Line | A21 URB. JARDINES DE HUMACAO
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-930-2402
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Fax |
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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 | 1081-PA
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License Number State | PR
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