Provider Demographics
NPI:1366631665
Name:CRUZ BERRIOS, CARISSA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:CARISSA
Middle Name:MARIE
Last Name:CRUZ BERRIOS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:G5 CALLE FLORENCIA AVE RAFAEL CORDERO
Mailing Address - Street 2:URB CAGUAS NORTE
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-402-0262
Mailing Address - Fax:939-697-6127
Practice Address - Street 1:E2 BOULEVARD OFFICE PLAZA
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-402-0262
Practice Address - Fax:939-697-6127
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2018-03-17
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Provider Licenses
StateLicense IDTaxonomies
PR16915207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine