Provider Demographics
NPI:1750734646
Name:RIOS, ELAINE MARIE (RD)
Entity type:Individual
Prefix:MISS
First Name:ELAINE
Middle Name:MARIE
Last Name:RIOS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 4 BOX 9079
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-7822
Mailing Address - Country:US
Mailing Address - Phone:787-669-6702
Mailing Address - Fax:
Practice Address - Street 1:HC 4 BOX 9079
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641-7822
Practice Address - Country:US
Practice Address - Phone:787-669-6702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1019828133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered