Healthcare Provider Details

I. General information

NPI: 1689391880
Provider Name (Legal Business Name): KEILY MATOS BERRIOS ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 CALLE BAILEN
DORADO PR
00646-5009
US

IV. Provider business mailing address

URB QUINTAS DE DORADO V17 CALLE AZAFRAN
DORADO PR
00646
US

V. Phone/Fax

Practice location:
  • Phone: 787-359-9378
  • Fax:
Mailing address:
  • Phone: 787-359-9378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number87
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number87
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: