Provider Demographics
NPI:1841496189
Name:RIOS, MYRANGELISSE (MD)
Entity type:Individual
Prefix:DR
First Name:MYRANGELISSE
Middle Name:
Last Name:RIOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 SAN JORGE STREET
Mailing Address - Street 2:SAN JORGE MEDICAL BUILDING SUITE 203
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00912
Mailing Address - Country:US
Mailing Address - Phone:787-726-0184
Mailing Address - Fax:787-727-7266
Practice Address - Street 1:258 SAN JORGE STREET
Practice Address - Street 2:SAN JORGE MEDICAL BUILDING SUITE 203
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912
Practice Address - Country:US
Practice Address - Phone:787-726-0184
Practice Address - Fax:787-727-7266
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR178002084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry