Provider Demographics
NPI:1972830966
Name:RIOS, ANTONIA (LND)
Entity Type:Individual
Prefix:MRS
First Name:ANTONIA
Middle Name:
Last Name:RIOS
Suffix:
Gender:F
Credentials:LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 CALLE 25 NE
Mailing Address - Street 2:URB PUERTO NUEVO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920-2531
Mailing Address - Country:US
Mailing Address - Phone:787-781-8272
Mailing Address - Fax:
Practice Address - Street 1:333 CALLE 25 NE
Practice Address - Street 2:URB PUERTO NUEVO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-2531
Practice Address - Country:US
Practice Address - Phone:787-480-5242
Practice Address - Fax:787-782-0476
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
721133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist