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General NPI Number Information
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NPI Number | 1881137412
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Entity Type | Individual
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Provider Name | AMALIA MARIE BONANO-RIOS MD
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Gender | Female
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Dates
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Enumeration Date | 11/30/2016
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 1757 ROCK QUARRY RD STE A
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-7303
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Country | US
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Telephone | 678-284-6575
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 864
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City | FAJARDO
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State | PR
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Zip | 00738-0864
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Country | US
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Telephone | 787-675-9913
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 103822
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 19715
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License Number State | PR
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