Provider Demographics
NPI:1881824837
Name:RIOS, LIBIA R (DDS)
Entity Type:Individual
Prefix:DR
First Name:LIBIA
Middle Name:R
Last Name:RIOS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 SW 157 AVE UNIT # 12
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1157
Mailing Address - Country:US
Mailing Address - Phone:786-536-5754
Mailing Address - Fax:786-409-5894
Practice Address - Street 1:8901 SW 157TH AVE UNIT 12
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1157
Practice Address - Country:US
Practice Address - Phone:786-536-5754
Practice Address - Fax:786-409-5894
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21001122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist