Individual
DR. PASTOR H RIOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
449 SE BAYA DRIVE, LAKE CITY, FL 32025
(386) 755-0500
(386) 755-9217
Mailing address
449 SE BAYA DRIVE, LAKE CITY, FL 32025
(386) 755-0500
(386) 755-9217
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME45687
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030461
AVMED PROVIDER NUMBER
FL
01
—
07742
BCBS PROVIDER NUMBER
FL
Enumeration date
10/03/2006
Last updated
07/09/2007
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