Provider Demographics
NPI:1174699557
Name:RIOS, JORGE A (MT)
Entity type:Individual
Prefix:MR
First Name:JORGE
Middle Name:A
Last Name:RIOS
Suffix:
Gender:M
Credentials:MT
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Mailing Address - Street 1:CALLE MATIAS BRUGMAN #98
Mailing Address - Street 2:BOX 50
Mailing Address - City:LAS MARIAS
Mailing Address - State:PR
Mailing Address - Zip Code:00670-0000
Mailing Address - Country:US
Mailing Address - Phone:787-827-4535
Mailing Address - Fax:787-827-4535
Practice Address - Street 1:CALLE MATIAS BRUGMAN #98
Practice Address - Street 2:LABORATORIO CLINICO RIOS LISOJO
Practice Address - City:LAS MARIAS
Practice Address - State:PR
Practice Address - Zip Code:00670-0000
Practice Address - Country:US
Practice Address - Phone:787-827-4535
Practice Address - Fax:787-827-4535
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR2070246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
38358Medicare ID - Type Unspecified