Provider Demographics
NPI:1336125301
Name:PARRILLA RIOS, MARCOS A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:A
Last Name:PARRILLA RIOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 HARBOUR LIGHTS DR
Mailing Address - Street 2:PALMAS DEL MAR
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-6053
Mailing Address - Country:US
Mailing Address - Phone:787-736-0252
Mailing Address - Fax:787-736-5545
Practice Address - Street 1:CALLE JOSE TOUS SOTO 108
Practice Address - Street 2:
Practice Address - City:SAN LORENZO
Practice Address - State:PR
Practice Address - Zip Code:00754
Practice Address - Country:US
Practice Address - Phone:787-736-0252
Practice Address - Fax:787-736-5545
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12258174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRBP4952289OtherFED. DRUG LICENCE
PRG41280Medicare UPIN
PR0088618Medicare ID - Type UnspecifiedPROVIDER ID