Provider Demographics
NPI:1780753236
Name:RIOS, AWILDA
Entity type:Individual
Prefix:MRS
First Name:AWILDA
Middle Name:
Last Name:RIOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC-02 BOX 7176
Mailing Address - Street 2:BO.CANABON
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794
Mailing Address - Country:US
Mailing Address - Phone:787-380-7543
Mailing Address - Fax:
Practice Address - Street 1:CARR 772 KM 7.8 BO.CANABON
Practice Address - Street 2:HC-02 BOX 7176
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794
Practice Address - Country:US
Practice Address - Phone:787-380-7543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician