Provider Demographics
NPI:1811241128
Name:BERRIOS OB-GYN, P.S.C.
Entity type:Organization
Organization Name:BERRIOS OB-GYN, P.S.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:J
Authorized Official - Last Name:BERRIOS ECHEVARRIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-961-4640
Mailing Address - Street 1:54 CAMINO DE LOS BUCARES
Mailing Address - Street 2:URB SABANERA DEL RIO
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-5209
Mailing Address - Country:US
Mailing Address - Phone:787-961-4640
Mailing Address - Fax:787-961-4673
Practice Address - Street 1:HIMA PLAZA ONE, SUITE 512
Practice Address - Street 2:AVE DEGETAU #500
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-961-4640
Practice Address - Fax:787-961-4673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-08
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13165207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty