Provider Demographics
NPI:1891253647
Name:BERRIOS RIOS, JESSICA M (MD, MPH)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:BERRIOS RIOS
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 75 BOX 1789
Mailing Address - Street 2:
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-9770
Mailing Address - Country:US
Mailing Address - Phone:787-385-3645
Mailing Address - Fax:
Practice Address - Street 1:CARR 878 KM 3.0
Practice Address - Street 2:BO ANONES
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-0071
Practice Address - Country:US
Practice Address - Phone:787-385-3645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-11
Last Update Date:2023-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR22748208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program