Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 9413 | PR |
NPI | 1023098449 |
---|---|
Provider Name | Dr. Fermin Heribel Berrios |
First Address | Bayamon, PR 00957-4309 |
Second Address | San Juan, PR 00936-0406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 08/07/2007 |