1083623839 NPI number — DR. MARVIN RIOS M.D.

Table of content: DR. MARVIN RIOS M.D. (NPI 1083623839)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083623839 NPI number — DR. MARVIN RIOS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIOS
Provider First Name:
MARVIN
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083623839
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/20/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O.BOX 652638
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33265-2638
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-223-3131
Provider Business Mailing Address Fax Number:
305-553-3888

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11880 SW 40TH ST STE 319
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33175-3574
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-223-3131
Provider Business Practice Location Address Fax Number:
305-553-3888
Provider Enumeration Date:
08/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  ME63202 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6035146002 . This is a "CIGNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 152851 . This is a "WELLCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 112938500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 173148 . This is a "JMH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 21149363532-02 . This is a "BEECH STREET CORPORATION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2391939 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 110950 . This is a "HUMANA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 772763 . This is a "FIRST HEALTH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1201096 . This is a "UNITED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 215900 . This is a "AMERIGROUP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 261960 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 59933 . This is a "VSTA OF SOUTH FLORIDA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: ME0063202 . This is a "VISTA HEALTH PLAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 279502 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 317 . This is a "PREFERRED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 33586 . This is a "NHP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 373979100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9104693 . This is a "PHCS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 373979100 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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