MEDICARE: DR. MANUEL A RODRIGUEZ RIOS M.D., A.B.M.C.M.

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	207Q00000X	Family Medicine Physician	007320	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	582113120	OTHER	PR	PROVIDER # FOR OTHER
2	28814	OTHER	PR	PROV # FOR TRIPLE S

General Provider Information

NPI Number	:	1871598599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANUEL A RODRIGUEZ RIOS M.D., A.B.M.C.M.

Provider Business Mailing Address
First Line	:	PO BOX 953
Second Line	:
City	:	MOROVIS
State	:	PR
Zip	:	00687-0953
Country	:	US
Telephone Number	:	787-862-3035
Fax Number	:	787-862-3035

Provider Business Practice Location Address
First Line	:	BUENA VISTA AVENUE # 5 SUITE 1
Second Line	:
City	:	MOROVIS
State	:	PR
Zip	:	00687
Country	:	US
Telephone Number	:	787-862-3035
Fax Number	:	787-862-3035

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	05/22/2009

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