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Monte Atenas Office Park Suite 205 San Juan PR 00926-7556 | |
| (787) 632-8703 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | Monte Atenas Office Park, San Juan, Puerto Rico |
| Authorized Official Name and Position | Adriana Lopez (CLINICAL PSYCHOLOGY) |
| Authorized Official Contact | 7876328703 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 261958 San Juan PR 00926-2649 Ph: (787) 632-8703 | Monte Atenas Office Park Suite 205 San Juan PR 00926-7556 Ph: (787) 632-8703 |
| NPI Number | 1174300552 |
|---|---|
| Provider Enumeration Date | 09/11/2023 |
| Last Update Date | 12/31/2024 |
| Certification Date | 12/23/2024 |
| Medicare PECOS PAC ID | 0446692941 |
|---|---|
| Medicare Enrollment ID | O20240530000043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174300552 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Adriana Lopez Motta |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427571009 PECOS PAC ID: 1355783853 Enrollment ID: I20240530000065 |
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