Provider Demographics
NPI:1730109356
Name:BERRIOS, MARIA A (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:BERRIOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:URB HERMANAS DAVILA
Mailing Address - Street 2:256 MUNOZ RIVERA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-5161
Mailing Address - Country:US
Mailing Address - Phone:787-505-3924
Mailing Address - Fax:787-998-9699
Practice Address - Street 1:3368 AVENIDA DEL VALLE
Practice Address - Street 2:LEVITTOWN
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-795-0704
Practice Address - Fax:787-998-9699
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15473208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0002-2788Medicare ID - Type Unspecified
PRI-27844Medicare UPIN