Provider Demographics
NPI:1578165791
Name:RIOFLORIDO, GINA HOCSON
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:HOCSON
Last Name:RIOFLORIDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 S STEPHENSON AVE
Mailing Address - Street 2:
Mailing Address - City:IRON MOUNTAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49801-3641
Mailing Address - Country:US
Mailing Address - Phone:906-779-7185
Mailing Address - Fax:906-779-3718
Practice Address - Street 1:1920 S STEPHENSON AVE
Practice Address - Street 2:
Practice Address - City:IRON MOUNTAIN
Practice Address - State:MI
Practice Address - Zip Code:49801-3641
Practice Address - Country:US
Practice Address - Phone:906-779-7185
Practice Address - Fax:906-779-3718
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315153062183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist