Provider Demographics
NPI:1083249254
Name:BERRIOS OUSLAN, BEATRIZ CRISTINA (DMD, MPH)
Entity type:Individual
Prefix:DR
First Name:BEATRIZ
Middle Name:CRISTINA
Last Name:BERRIOS OUSLAN
Suffix:
Gender:F
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3304 GREENWALD WAY N
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-0768
Mailing Address - Country:US
Mailing Address - Phone:407-520-3595
Mailing Address - Fax:
Practice Address - Street 1:3304 GREENWALD WAY N
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-0768
Practice Address - Country:US
Practice Address - Phone:407-520-3595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-09
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLDN25763122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program