MEDICARE: DR. TABATHA L RIOS M.D.

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	36137078	IL
2	207Q00000X	Family Medicine Physician	ME138093	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912273012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TABATHA L RIOS M.D.

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:	305-500-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	28516 STATE ROAD 54
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-3210
Country	:	US
Telephone Number	:	813-815-8391
Fax Number	:	813-761-3347

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

Provider Enumeration Date	:	03/23/2012
Last Update Date	:	04/15/2025

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