Provider Demographics
NPI:1740241009
Name:CEDRES-RIOS, MYRIAM (MD)
Entity Type:Individual
Prefix:MS
First Name:MYRIAM
Middle Name:
Last Name:CEDRES-RIOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:Y-26 BLVD MONROIG AVE LEVITTOWN
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-795-4067
Mailing Address - Fax:787-795-4067
Practice Address - Street 1:Y-26 BLVD MONROIG AVE LEVITTOWN
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-795-4067
Practice Address - Fax:787-795-4067
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9040208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR9040OtherPHYSICIAN/OSTEOPATH