Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | CP003225 | PR |
N | 225000000X | Orthotic Fitter | CFO01075 | PR |
NPI | 1659526879 |
---|---|
Provider Name | Felix Berrios |
First Address | San Juan, PR 00921-3201 |
Second Address | San Juan, PR 00921-3201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2008 |
Last Update Date | 02/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C18363 | BOARD FOR CERTIFICATION (01) | MD |
CFO01075 | AMERICAN BOARD FOR CERTIFICATION (01) | DE |
CP003225 | AMERICAN BOARD CERTIFICATION (01) | DE |