| Doctor Name: | WANDA M BERRIOS |
| NPI Number: | 1932216496 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 13686 |
| Business Practice Address: | 3100 17th St Saint Cloud, FL - 347696021 |
| Business Phone Number: | 4078920009 |
| Business Fax Number: | 4078923285 |
| Mailing Address: | 3100 17th St, SAINT CLOUD |
| State: | FL |
| Postal Code: | 347696021 |
| Phone Number: | 4078920009 |
| Fax Number: | 4078923285 |
| NPI Enumeration Date: | 08/23/2006 |
| NPI Last Update Date: | 08/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 13686 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |