Provider Demographics
NPI:1972195873
Name:BERRIOS RIVERA, KAREN (NP-C)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BERRIOS RIVERA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:BERRIOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16594 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-1325
Mailing Address - Country:US
Mailing Address - Phone:813-933-1944
Mailing Address - Fax:
Practice Address - Street 1:16594 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-1325
Practice Address - Country:US
Practice Address - Phone:813-933-1944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11011426363LA2200X, 363LG0600X, 363LP2300X
FLAPRN11011426363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care