| Clinicamente Llc | |
|
Calle Santa Cruz 68 Suite 606 Bayamon PR 00961 | |
| (787) 909-5359 | |
| Not Available |
| Full Name | Clinicamente Llc |
|---|---|
| Speciality | Psychologist |
| Location | Calle Santa Cruz 68, Bayamon, Puerto Rico |
| Authorized Official Name and Position | Tainari Davila Rodriguez (EMPLOYEE) |
| Authorized Official Contact | 7879095359 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinicamente Llc Po Box 10282 San Juan PR 00922-0282 Ph: (787) 909-5359 | Clinicamente Llc Calle Santa Cruz 68 Suite 606 Bayamon PR 00961 Ph: (787) 909-5359 |
| NPI Number | 1700574100 |
|---|---|
| Provider Enumeration Date | 04/25/2023 |
| Last Update Date | 04/25/2023 |
| Certification Date | 04/17/2023 |
| Medicare PECOS PAC ID | 3577921121 |
|---|---|
| Medicare Enrollment ID | O20230614001948 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700574100 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tainari Davila Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407278450 PECOS PAC ID: 5193954394 Enrollment ID: I20140211001026 |
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