Organization
JOSE L BERLIOZ MD PA
Active
Other names
Safari Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY KAFATI (GENERAL MANAGER)
(956) 763-6335
Entity
Organization
Contact information
Practice address
10710 MCPHERSON RD STE 101, LAREDO, TX 78045-6363
(956) 724-7145
(956) 724-4944
Mailing address
PO BOX 450594, LAREDO, TX 78045-0014
(956) 724-7145
(956) 724-4865
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0036GW
BCBS
TX
05
—
144557901
—
TX
05
—
144557902
—
TX
05
—
144557903
—
TX
Enumeration date
07/16/2006
Last updated
01/03/2023
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