Provider Demographics
NPI:1417696022
Name:BERRIOS SURILLO, ANA GABRIELA (DC)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:GABRIELA
Last Name:BERRIOS SURILLO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 TURNING LEAF CIRCLE
Mailing Address - Street 2:APT 323
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316
Mailing Address - Country:US
Mailing Address - Phone:787-467-2611
Mailing Address - Fax:
Practice Address - Street 1:6015 WADE HAMPTON BLVD STE D
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-5334
Practice Address - Country:US
Practice Address - Phone:864-655-5850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE