Provider Demographics
NPI:1154305068
Name:RIOS BONILLA, MARIA L (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:L
Last Name:RIOS BONILLA
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 1:358 CALLE FONT MARTELO
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-3222
Mailing Address - Country:US
Mailing Address - Phone:787-850-1720
Mailing Address - Fax:787-852-4275
Practice Address - Street 1:358 CALLE FONT MARTELO
Practice Address - Street 2:SUITE 103
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3222
Practice Address - Country:US
Practice Address - Phone:787-850-1720
Practice Address - Fax:787-852-4275
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5802207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease