Ab Derm LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

AB DERM LLC

Practice address

66 Calle Santa Cruz
Ste 303 Instituto San Pablo
Bayamon, PR 00961-7049

Phone

(787) 705-2944

Fax

(787) 705-2943

NPI assigned

Aug 17, 2023

Last updated

Aug 17, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gabriel Eduardo Arias Berrios, MD

Title

Sole Owner

Phone

(787) 646-1910

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gabriel Eduardo Arias Berrios, MD

  • Dermatology Physician
  • Bayamon, PR
  • NPI 1053869586
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1982487351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 CALLE SANTA CRUZ",
            "address_2": "STE 303 INSTITUTO SAN PABLO",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617049",
            "telephone_number": "787-705-2944",
            "fax_number": "787-705-2943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 CALLE SANTA CRUZ",
            "address_2": "STE 303 INSTITUTO SAN PABLO",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617049",
            "telephone_number": "787-705-2944",
            "fax_number": "787-705-2943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AB DERM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-16",
        "status": "A",
        "authorized_official_last_name": "ARIAS BERRIOS",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_middle_name": "EDUARDO",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "787-646-1910",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Bayamon, PR
• Providers in Bayamon, PR by specialty
• Dermatology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.