Individual
SAMUEL DEL RIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
255 FORTENBERRY RD, SUITE A-1, MERRITT ISLAND, FL 32952-3601
(321) 459-1192
(321) 459-2304
Mailing address
PO BOX 11406, BELFAST, ME 04915-4005
(321) 459-1192
(321) 459-2304
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
ME0075762
FL
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
ME75762
FL
207VG0400X
Gynecology Physician
Primary
ME75762
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254387700
—
FL
Enumeration date
04/19/2006
Last updated
04/15/2015
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