Individual
MRS. JACQUELINE RIOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DR.OT
Contact information
Practice address
4545 SW 104TH AVE, MIAMI, FL 33165-5634
(305) 221-0284
Mailing address
11825 SW 99TH AVE, MIAMI, FL 33176-4111
(786) 985-1619
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT 10519
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
887774200
—
FL
Enumeration date
01/31/2012
Last updated
01/31/2012
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