Provider Demographics
NPI:1699234807
Name:BERRIOS, STEPHANIE (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:BERRIOS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:APT 3L LAGUNA GARDENS 4
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:445 PASEOS DE DORADO
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-236-2922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000671111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No111NR0400XChiropractic ProvidersChiropractorRehabilitation