Healthcare Provider Details

I. General information

NPI: 1407859820
Provider Name (Legal Business Name): RAMON R BERRIOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 04/10/2020
Certification Date: 04/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 AVE F D ROOSEVELT MEZZANINE - SUITE B
GUAYNABO PR
00968-2695
US

IV. Provider business mailing address

PO BOX 1036
GUAYNABO PR
00970-1036
US

V. Phone/Fax

Practice location:
  • Phone: 787-706-4334
  • Fax: 787-749-0993
Mailing address:
  • Phone: 787-706-4334
  • Fax: 787-749-0993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number9651
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: