Healthcare Provider Details

I. General information

NPI: 1326972019
Provider Name (Legal Business Name): BIANCA C BERRIOS ROSARIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 S SEMORAN BLVD STE A
ORLANDO FL
32807-1424
US

IV. Provider business mailing address

3515 SPINNING REEL LN
KISSIMMEE FL
34746-1845
US

V. Phone/Fax

Practice location:
  • Phone: 787-484-6819
  • Fax:
Mailing address:
  • Phone: 787-484-6819
  • Fax: 787-484-6819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: