Provider Demographics
NPI:1124034418
Name:ARROYO BERRIOS, ALIDA (MD)
Entity type:Individual
Prefix:DR
First Name:ALIDA
Middle Name:
Last Name:ARROYO BERRIOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 STREET URB. JARDINES DE COUNTRY CLUB
Mailing Address - Street 2:CO-12
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-2043
Mailing Address - Country:US
Mailing Address - Phone:787-449-1963
Mailing Address - Fax:787-257-2388
Practice Address - Street 1:153 STREET URB. JARDINES DE COUNTRY CLUB
Practice Address - Street 2:CO-12
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-2043
Practice Address - Country:US
Practice Address - Phone:787-449-1963
Practice Address - Fax:787-257-2388
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055724208000000X
PR17188225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA514387421AMedicaid