Provider Demographics
NPI:1811494438
Name:BERRIOS BONES, DANIEL (LMT)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:BERRIOS BONES
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 191147
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-1147
Mailing Address - Country:US
Mailing Address - Phone:787-596-0358
Mailing Address - Fax:
Practice Address - Street 1:177 AVE DE DIEGO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-6310
Practice Address - Country:US
Practice Address - Phone:787-596-0358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000217173C00000X, 226300000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No173C00000XOther Service ProvidersReflexologist
No226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist