Provider Demographics
NPI:1194833103
Name:BERIO ROUSSEL, FRANCISCO A (MD)
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:A
Last Name:BERIO ROUSSEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CALLE LAS MERCEDES
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783-1924
Mailing Address - Country:US
Mailing Address - Phone:787-859-7404
Mailing Address - Fax:
Practice Address - Street 1:25 CALLE LAS MERCEDES
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-1924
Practice Address - Country:US
Practice Address - Phone:787-859-7404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16502208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice