Healthcare Provider Details

I. General information

NPI: 1407896772
Provider Name (Legal Business Name): DAGMA E. FERNANDEZ BERRIOS M.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB CONDADO VIEJO H17 CALLE JOSE VILLARES
CAGUAS PR
00725-2463
US

IV. Provider business mailing address

212 CALLE SAN IGNACIO URB. LIRIOS CALA
JUNCOS PR
00777-8625
US

V. Phone/Fax

Practice location:
  • Phone: 787-486-0255
  • Fax:
Mailing address:
  • Phone: 787-486-0255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6562
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: