Healthcare Provider Details

I. General information

NPI: 1124034418
Provider Name (Legal Business Name): ALIDA ARROYO BERRIOS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 04/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 STREET URB. JARDINES DE COUNTRY CLUB CO-12
CAROLINA PR
00983-2043
US

IV. Provider business mailing address

153 STREET URB. JARDINES DE COUNTRY CLUB CO-12
CAROLINA PR
00983-2043
US

V. Phone/Fax

Practice location:
  • Phone: 787-449-1963
  • Fax: 787-257-2388
Mailing address:
  • Phone: 787-449-1963
  • Fax: 787-257-2388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number055724
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number17188
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: