Provider Demographics
NPI:1558435529
Name:MUNOZ BERRIOS, MARIA S (DR)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:S
Last Name:MUNOZ 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 1:791 CALLE GUATEMALA
Mailing Address - Street 2:LAS AMERICAS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-2308
Mailing Address - Country:US
Mailing Address - Phone:787-309-8754
Mailing Address - Fax:
Practice Address - Street 1:GO35 AVE ROBERTO SANCHEZ VILELLA
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-2678
Practice Address - Country:US
Practice Address - Phone:787-309-8754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR954103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR532040Medicare UPIN