Healthcare Provider Details

I. General information

NPI: 1326607441
Provider Name (Legal Business Name): MAYRA BERRIOS RCM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2019
Last Update Date: 06/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE LIRIO #15 URB. QUINTAS DE CIALES
CIALES PR
00638
US

IV. Provider business mailing address

PO BOX 696
CIALES PR
00638-0696
US

V. Phone/Fax

Practice location:
  • Phone: 787-349-1454
  • Fax:
Mailing address:
  • Phone: 787-349-1454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number00672
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code225CX0006X
TaxonomyOrientation and Mobility Training Rehabilitation Counselor
License Number00672
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: