Provider Demographics
NPI:1649541905
Name:RIOS, MARISOL (RN)
Entity type:Individual
Prefix:
First Name:MARISOL
Middle Name:
Last Name:RIOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CALLE D
Mailing Address - Street 2:URB. PEPINO
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-2009
Mailing Address - Country:US
Mailing Address - Phone:787-454-7863
Mailing Address - Fax:
Practice Address - Street 1:CARR 107 # KM 2/3
Practice Address - Street 2:PLAZA DEL MAR
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-5970
Practice Address - Country:US
Practice Address - Phone:787-641-9133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR031582163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice