Provider Demographics
NPI:1659534824
Name:DEL RIO, LUIS SENEN III (DC)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:SENEN
Last Name:DEL RIO
Suffix:III
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 1:820 PALMWAY ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-4542
Mailing Address - Country:US
Mailing Address - Phone:407-931-3700
Mailing Address - Fax:407-931-3710
Practice Address - Street 1:820 PALMWAY ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4542
Practice Address - Country:US
Practice Address - Phone:407-931-3700
Practice Address - Fax:407-931-3710
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9582111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor