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General NPI Number Information
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NPI Number | 1689014920
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Entity Type | Individual
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Provider Name | MATTHEW WILLIAM BERRIOS D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/01/2013
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 7375 CYPRESS GARDENS BLVD
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City | WINTER HAVEN
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State | FL
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Zip | 33884-3246
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Country | US
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Telephone | 863-325-8185
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Fax | 813-742-5051
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Provider Business Mailing Address
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Address Line | 12227 STONELAKE RANCH BLVD
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City | THONOTOSASSA
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State | FL
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Zip | 33592-3910
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Country | US
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Telephone | 813-644-2463
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | OT015487
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | OS13897
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License Number State | FL
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