MEDICARE: AIDA DEL RIO P.A.

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	363AM0700X	Medical Physician Assistant	PA 3493	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700945102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIDA DEL RIO P.A.

Provider Business Mailing Address
First Line	:	4800 SW 141ST AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-4820
Country	:	US
Telephone Number	:	305-554-0609
Fax Number	:

Provider Business Practice Location Address
First Line	:	242 NW 42ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-5435
Country	:	US
Telephone Number	:	305-448-0809
Fax Number	:	305-448-9123

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

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	07/08/2007

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Directions to “ AIDA DEL RIO P.A.” Practice Location

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