Provider Demographics
NPI:1235761206
Name:BERRIOS, GILMARIE (DR)
Entity Type:Individual
Prefix:
First Name:GILMARIE
Middle Name:
Last Name:BERRIOS
Suffix:
Gender:F
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB CASAMIA CALLE ZORZAL 5109
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-3400
Mailing Address - Country:US
Mailing Address - Phone:787-974-8365
Mailing Address - Fax:
Practice Address - Street 1:URB CASAMIA CALLE ZORZAL 5109
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-3400
Practice Address - Country:US
Practice Address - Phone:787-974-8365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6180103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical