Provider Demographics
NPI:1770198574
Name:FELIX BERRIOS, ROBERTO
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:FELIX BERRIOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:F36 CALLE BELLISIMA
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-3251
Mailing Address - Country:US
Mailing Address - Phone:939-464-0979
Mailing Address - Fax:
Practice Address - Street 1:C17 CALLE MARGINAL
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6706
Practice Address - Country:US
Practice Address - Phone:939-464-0979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23619208D00000X
PR16472-I390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice