Provider Demographics
NPI:1598523722
Name:RIOS, ADRIANA (PA-C)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:RIOS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2357 ALAQUA DR
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-3123
Mailing Address - Country:US
Mailing Address - Phone:407-486-4236
Mailing Address - Fax:
Practice Address - Street 1:1150 DOUGLAS AVE STE 1100
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2098
Practice Address - Country:US
Practice Address - Phone:407-486-4236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9117854363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant