MEDICARE: BIANCA C BERRIOS ROSARIO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1326972019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BIANCA C BERRIOS ROSARIO

Provider Business Mailing Address
First Line	:	3515 SPINNING REEL LN
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-1845
Country	:	US
Telephone Number	:	787-484-6819
Fax Number	:	787-484-6819

Provider Business Practice Location Address
First Line	:	1150 S SEMORAN BLVD STE A
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32807-1424
Country	:	US
Telephone Number	:	787-484-6819
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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