Provider Demographics
NPI:1376571984
Name:RIOS, MYRIAM SOCORRO (MD)
Entity Type:Individual
Prefix:
First Name:MYRIAM
Middle Name:SOCORRO
Last Name:RIOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MIRIAM
Other - Middle Name:SOCORRO
Other - Last Name:RIOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 4952
Mailing Address - Street 2:CAGUAS
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-4952
Mailing Address - Country:US
Mailing Address - Phone:787-744-8370
Mailing Address - Fax:
Practice Address - Street 1:T1-11 CALLE 28
Practice Address - Street 2:CAGUAS
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-5902
Practice Address - Country:US
Practice Address - Phone:787-744-8370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11395207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3538OtherPREFERRED MEDICARE CHOICE
PR89864OtherTRIPLE S
PR200357OtherPREFERRED HEALTH
PR061313OtherCRUZ AZUL DE PR
PR5068OtherFIRST MEDICAL
PR7250064OtherHUMANA INSURANCE
PR7250064OtherHUMANA HEALTH PLAN
PR2027OtherAMERICAN HEALTH
PRPE4136OtherPALIC PROVIDER
PRPE4136OtherPALIC PROVIDER
PRH82127Medicare UPIN