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Individual

ANTONIO L RIOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1 BALTIMORE PL NW STE 400, ATLANTA, GA 30308-2117
(404) 885-9675
(404) 875-4017
Mailing address
3260 SPAIN RD, SNELLVILLE, GA 30039-8574
(678) 361-3584
(770) 558-3419

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN037456
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000550459E
GA
05
000550459G
GA
01
1487691580
NPI
GA
01
1982637419
GROUP NPI
GA
01
N334027
WELLCARE MEDICAID
GA
01
P00201874
RR MEDICARE
GA
Enumeration date
05/31/2006
Last updated
03/30/2018
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