Provider Demographics
NPI:1629051388
Name:BERRIOS, CARMEN M (RN)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:M
Last Name:BERRIOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 73
Mailing Address - Street 2:BOX 6190
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-9804
Mailing Address - Country:US
Mailing Address - Phone:787-263-7144
Mailing Address - Fax:717-764-9904
Practice Address - Street 1:AVENIDOS 65 INFANTERIC
Practice Address - Street 2:KM 1 HM 3.4, BARRIO SABANA ILANA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924
Practice Address - Country:US
Practice Address - Phone:787-767-7676
Practice Address - Fax:787-764-9904
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6176163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice