Provider Demographics
NPI:1861603490
Name:RIOS, IRIS JANNETTE (AX)
Entity type:Individual
Prefix:MS
First Name:IRIS
Middle Name:JANNETTE
Last Name:RIOS
Suffix:
Gender:F
Credentials:AX
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-0015
Mailing Address - Country:US
Mailing Address - Phone:787-312-4462
Mailing Address - Fax:787-857-4280
Practice Address - Street 1:ROAD156 KM13.4 BO.PALO HINCADO
Practice Address - Street 2:
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794
Practice Address - Country:US
Practice Address - Phone:787-857-3980
Practice Address - Fax:787-857-4280
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2780183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician