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General NPI Number Information
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NPI Number | 1366631665
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Entity Type | Individual
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Provider Name | CARISSA MARIE CRUZ BERRIOS M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/23/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | E2 BOULEVARD OFFICE PLAZA
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-402-0262
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Fax | 939-697-6127
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Provider Business Mailing Address
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Address Line | G5 CALLE FLORENCIA AVE RAFAEL CORDERO URB CAGUAS NORTE
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City | CAGUAS
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State | PR
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Zip | 00725
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Country | US
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Telephone | 787-402-0262
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Fax | 939-697-6127
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 16915
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 16915
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License Number State | PR
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