Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME0052177 | FL |
N | 207YP0228X | Pediatric Otolaryngology | ME0052177 | FL |
NPI | 1053377754 |
---|---|
Provider Name | Dr. Jose Alberto Berrios |
First Address | Palm Harbor, FL 34685-2011 |
Second Address | Palm Harbor, FL 34685-2011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2006 |
Last Update Date | 10/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02978 | WELLCARE (01) | |
040014067 | RR MEDICARE (01) | |
047382100 | (05) | FL |
0600062 | GHI (01) | |
209756 | AMERIGROUP (01) | |
214676 | AVMED (01) | |
593341132 | TAX ID (01) | |
7A7011 | EMPIRE BLUE CROSS NY (01) | |
D61176 | (02) | FL |
ZA5283 | BLUE CROSS MASSACHUSETTS (01) |