Provider Demographics
NPI:1598425415
Name:RIOS RIVERA, RAYMAR OMY (DC)
Entity Type:Individual
Prefix:DR
First Name:RAYMAR
Middle Name:OMY
Last Name:RIOS RIVERA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 PASEO LA COLONIA STE 3
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-2253
Mailing Address - Country:US
Mailing Address - Phone:787-987-8710
Mailing Address - Fax:
Practice Address - Street 1:1805 PASEO LA COLONIA STE 3
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-2253
Practice Address - Country:US
Practice Address - Phone:787-987-8710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-20
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR772111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor