Provider Demographics
NPI:1407175383
Name:BERLLINGERI, JOSE ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ANTONIO
Last Name:BERLLINGERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4837 AVE ISLA VERDE
Mailing Address - Street 2:APT. 1109
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-5418
Mailing Address - Country:US
Mailing Address - Phone:787-268-3147
Mailing Address - Fax:787-268-3147
Practice Address - Street 1:4837 AVE ISLA VERDE
Practice Address - Street 2:APT. 1109
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-5418
Practice Address - Country:US
Practice Address - Phone:787-268-3147
Practice Address - Fax:787-268-3147
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR29492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD34233Medicare UPIN