Provider Demographics
NPI:1891996559
Name:BERRIOS, JULIA E (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:E
Last Name:BERRIOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 JASMINE LN
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-8688
Mailing Address - Country:US
Mailing Address - Phone:843-662-0144
Mailing Address - Fax:
Practice Address - Street 1:696 MUCKERMAN RD
Practice Address - Street 2:
Practice Address - City:BENNETTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29512-6195
Practice Address - Country:US
Practice Address - Phone:843-454-8200
Practice Address - Fax:843-454-8324
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6125208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice