Provider Demographics
NPI:1104043983
Name:RIOS, AITZA B (MD)
Entity Type:Individual
Prefix:DR
First Name:AITZA
Middle Name:B
Last Name:RIOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1303
Mailing Address - Street 2:
Mailing Address - City:GUANICA
Mailing Address - State:PR
Mailing Address - Zip Code:00653-1303
Mailing Address - Country:US
Mailing Address - Phone:939-717-4213
Mailing Address - Fax:
Practice Address - Street 1:99 CALLE GUILLERMO RIEFKOHL
Practice Address - Street 2:CENTRO DE SERVICIOS PRIMARIOS DE SALUD DE PATILLAS
Practice Address - City:PATILLAS
Practice Address - State:PR
Practice Address - Zip Code:00723
Practice Address - Country:US
Practice Address - Phone:787-839-4320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12456208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6254534OtherFD
PR12792-8OtherDM
PR12456OtherLICENCIA