Basic Information
| Provider Information | |||||||||
| NPI: | 1700945102 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEL RIO | ||||||||
| FirstName: | AIDA | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4800 SW 141ST AVE | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331754820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055540609 | ||||||||
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| Practice Location | |||||||||
| Address1: | 242 NW 42ND AVE | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331265435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054480809 | ||||||||
| FaxNumber: | 3054489123 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/08/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA 3493 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.