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2604 Ave Las Americas Ponce PR 00717-2107 | |
| (787) 632-7465 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 2604 Ave Las Americas, Ponce, Puerto Rico |
| Authorized Official Name and Position | Nilde Silvia Cordoliani (PRESIDENT) |
| Authorized Official Contact | 7879759968 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1915 Calle Zarina Ponce PR 00716-0510 Ph: (787) 975-9968 | 2604 Ave Las Americas Ponce PR 00717-2107 Ph: (787) 632-7465 |
| NPI Number | 1609006576 |
|---|---|
| Provider Enumeration Date | 07/24/2009 |
| Last Update Date | 07/24/2009 |
| Medicare PECOS PAC ID | 8921270166 |
|---|---|
| Medicare Enrollment ID | O20111011000632 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609006576 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Carlos A Aviles Gonzalez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659419810 PECOS PAC ID: 3577634435 Enrollment ID: I20080619000707 |
| Provider Name | Annette M Martinez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205864717 PECOS PAC ID: 6507039203 Enrollment ID: I20111025000273 |
| Provider Name | Nilde J Defendini Cordoliani |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326378498 PECOS PAC ID: 5193997336 Enrollment ID: I20111025000308 |
| Provider Name | Nadia Enid Rivera Vega |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356103071 PECOS PAC ID: 9133669211 Enrollment ID: I20240904004375 |
Mente Activa Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 775 Calle Caoba, Centro Comercial Los Caobos, Suite 10, Ponce, PR 00716 Phone: 787-677-0503 | |
Pax De Puerto Rico Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: Jardines Del Caribe 49, Yy46, Ponce, PR 00731 Phone: 787-644-9925 | |
Hope Center Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: Edificio Porrata Pila, 2431 Blvd Luis A Ferre Suite 208, Ponce, PR 00717 Phone: 787-404-1645 | |
Vanessa Berrios Ph D & Associados Psc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2275 Ponce By Pass, Ponce, PR 00717 Phone: 787-290-1111 Fax: 787-290-1111 | |