Provider Demographics
NPI:1689014920
Name:BERRIOS, MATTHEW WILLIAM (DO)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:WILLIAM
Last Name:BERRIOS
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12227 STONELAKE RANCH BLVD
Mailing Address - Street 2:
Mailing Address - City:THONOTOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:33592-3910
Mailing Address - Country:US
Mailing Address - Phone:813-644-2463
Mailing Address - Fax:
Practice Address - Street 1:7375 CYPRESS GARDENS BLVD
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-3246
Practice Address - Country:US
Practice Address - Phone:863-325-8185
Practice Address - Fax:813-742-5051
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT015487207P00000X
FLOS13897207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine