Provider Demographics
NPI:1225094675
Name:BERIO, ANGEL F (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:F
Last Name:BERIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:782 NW 42ND AVE
Mailing Address - Street 2:#340
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5541
Mailing Address - Country:US
Mailing Address - Phone:305-461-4559
Mailing Address - Fax:305-461-6487
Practice Address - Street 1:782 NW 42ND AVE
Practice Address - Street 2:340
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5541
Practice Address - Country:US
Practice Address - Phone:305-461-4559
Practice Address - Fax:305-461-6487
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME21620208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL036976400Medicaid
FL30094Medicare ID - Type Unspecified
FLD08756Medicare UPIN