Provider Demographics
NPI:1770109316
Name:RIOS LEITE, DANIELE (MD)
Entity type:Individual
Prefix:
First Name:DANIELE
Middle Name:
Last Name:RIOS LEITE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:DANIELE
Other - Middle Name:
Other - Last Name:RIOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 44008
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4008
Mailing Address - Country:US
Mailing Address - Phone:904-244-8846
Mailing Address - Fax:904-244-8844
Practice Address - Street 1:653-1 W 8TH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6511
Practice Address - Country:US
Practice Address - Phone:904-244-8846
Practice Address - Fax:904-244-8844
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL36621207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty