Basic Information
Provider Information
NPI: 1285896787
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RIOS-GERENA
FirstName: AMARIS
MiddleName: ENID
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6400 SHAFER CT STE 700
Address2:  
City: ROSEMONT
State: IL
PostalCode: 600184989
CountryCode: US
TelephoneNumber: 3463761702
FaxNumber: 2245322780
Practice Location
Address1: 5200 NE 2ND AVE FL 3
Address2:  
City: MIAMI
State: FL
PostalCode: 331372706
CountryCode: US
TelephoneNumber: 3057623883
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/26/2008
LastUpdateDate: 11/10/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/09/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0002XME135425FLY Allopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine

No ID Information.


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