MEDICARE: DR. CYNTHIA A BERRIOS PSYCHOLOGIST

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	103T00000X	Psychologist	1646	PR

General Provider Information

NPI Number	:	1619130119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA A BERRIOS PSYCHOLOGIST

Provider Business Mailing Address
First Line	:	1474 AVE SAN IGNACIO
Second Line	:	URB. ALTAMESA
City	:	SAN JUAN
State	:	PR
Zip	:	00921-4739
Country	:	US
Telephone Number	:	787-707-1090
Fax Number	:	787-707-1090

Provider Business Practice Location Address
First Line	:	1474 AVE SAN IGNACIO
Second Line	:	URB. ALTAMESA
City	:	SAN JUAN
State	:	PR
Zip	:	00921-4739
Country	:	US
Telephone Number	:	787-707-1090
Fax Number	:	787-707-1090

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

Provider Enumeration Date	:	07/03/2008
Last Update Date	:	07/03/2008

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