Healthcare Provider Details

I. General information

NPI: 1265657530
Provider Name (Legal Business Name): MARITZA BERRIOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 05/11/2025
Certification Date: 05/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 CALLE 20
GUAYNABO PR
00969-4450
US

IV. Provider business mailing address

299 CALLE 20
GUAYNABO PR
00969-4450
US

V. Phone/Fax

Practice location:
  • Phone: 787-205-7332
  • Fax:
Mailing address:
  • Phone: 787-205-7332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number371
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: