Provider Demographics
NPI:1821072935
Name:RIOS, GRISSEL (MD)
Entity Type:Individual
Prefix:
First Name:GRISSEL
Middle Name:
Last Name: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:AVE ROOSEVELT 400 CLINICAS LAS AMERICAS
Mailing Address - Street 2:SUITE 404
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-765-3245
Mailing Address - Fax:787-765-0569
Practice Address - Street 1:AVE ROOSEVELT 400 CLINICAS LAS AMERICAS
Practice Address - Street 2:SUITE 404
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-765-3245
Practice Address - Fax:787-765-0569
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13344207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR20898Medicare ID - Type Unspecified