Provider Demographics
NPI:1831298371
Name:RIOS, JAVIER F III
Entity type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:F
Last Name:RIOS
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:APT.2703 BRISAS DEL PARQUE ESCORIAL
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-5149
Mailing Address - Country:US
Mailing Address - Phone:787-587-1157
Mailing Address - Fax:
Practice Address - Street 1:CALLE AGUSTIN CABRERA 5456
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-768-0966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15159208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR22087Medicare ID - Type Unspecified
PRI01084Medicare UPIN