Provider Demographics
NPI:1477758902
Name:JOHN P RIOUX MD PL
Entity Type:Organization
Organization Name:JOHN P RIOUX MD PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:RIOUX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-625-4270
Mailing Address - Street 1:21260 OLEAN BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-6705
Mailing Address - Country:US
Mailing Address - Phone:941-625-4270
Mailing Address - Fax:941-625-1751
Practice Address - Street 1:21260 OLEAN BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-6705
Practice Address - Country:US
Practice Address - Phone:941-625-4270
Practice Address - Fax:941-625-1751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72810208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5541Medicare ID - Type Unspecified
FLG57719Medicare UPIN