MEDICARE: KARMIN JEMARIE RODRIGUEZ RIOS

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	1041C0700X	Clinical Social Worker	9686	PR

General Provider Information

NPI Number	:	1306215843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARMIN JEMARIE RODRIGUEZ RIOS

Provider Business Mailing Address
First Line	:	147 CALLE MADAGASCAR
Second Line	:
City	:	LAS PIEDRAS
State	:	PR
Zip	:	00771-3472
Country	:	US
Telephone Number	:	787-505-7571
Fax Number	:

Provider Business Practice Location Address
First Line	:	147 CALLE MADAGASCAR
Second Line	:
City	:	LAS PIEDRAS
State	:	PR
Zip	:	00771-3472
Country	:	US
Telephone Number	:	787-505-7571
Fax Number	:

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

Provider Enumeration Date	:	09/15/2015
Last Update Date	:	09/15/2015

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