Healthcare Provider Details

I. General information

NPI: 1730005034
Provider Name (Legal Business Name): DESIREE LEON BERRIOS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE SANTA CRUZ, URB # 70
BAYAMON PR
00956
US

IV. Provider business mailing address

5 CALLE AMAPOLA APT 303
SAN JUAN PR
00927-4257
US

V. Phone/Fax

Practice location:
  • Phone: 787-620-4747
  • Fax:
Mailing address:
  • Phone: 787-215-4454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: