Provider Demographics
NPI:1497985501
Name:BERRIOS ORTIZ, LISETTE MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:LISETTE
Middle Name:MARIA
Last Name:BERRIOS ORTIZ
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 1:434 VIA MORITZ
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-4642
Mailing Address - Country:US
Mailing Address - Phone:561-267-6295
Mailing Address - Fax:
Practice Address - Street 1:434 VIA MORITZ
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-4642
Practice Address - Country:US
Practice Address - Phone:561-267-6295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14682207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine