MEDICARE: LUIS ENRIQUE RIOS BRIGNONI ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	11001427	FL

General Provider Information

NPI Number	:	1083276034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUIS ENRIQUE RIOS BRIGNONI ARNP

Provider Business Mailing Address
First Line	:	PO BOX 209
Second Line	:
City	:	RINCON
State	:	PR
Zip	:	00677-0209
Country	:	US
Telephone Number	:	787-371-1667
Fax Number	:

Provider Business Practice Location Address
First Line	:	6328 GUNN HWY STE C
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33625-4101
Country	:	US
Telephone Number	:	813-610-9510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2019
Last Update Date	:	06/30/2019

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