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Individual

DR. JOSE ALBERTO BERRIOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
800 TARPON WOODS BLVD, SUITE D, PALM HARBOR, FL 34685-2011
(727) 942-4005
(727) 934-1773
Mailing address
800 TARPON WOODS BLVD, SUITE D, PALM HARBOR, FL 34685-2011
(727) 942-4005
(727) 934-1773

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME0052177
FL
207YP0228X
Pediatric Otolaryngology Physician
ME0052177
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02978
WELLCARE
01
040014067
RR MEDICARE
05
047382100
FL
01
0600062
GHI
01
209756
AMERIGROUP
01
214676
AVMED
01
593341132
TAX ID
01
7A7011
EMPIRE BLUE CROSS NY
01
ZA5283
BLUE CROSS MASSACHUSETTS
Enumeration date
04/22/2006
Last updated
10/10/2011
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