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Ave Americo Miranda Aptdo 29134 Centro Medico De Pr Edif. Principal Escuela De Medicina San Juan PR 00929-0134 | |
| (787) 758-2525 | |
| (787) 274-8156 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | Ave Americo Miranda Aptdo 29134 Centro Medico De Pr, San Juan, Puerto Rico |
| Authorized Official Name and Position | Myriam Troche (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 7877582525 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 29134 San Juan PR 00929-0134 Ph: (787) 758-2525 | Ave Americo Miranda Aptdo 29134 Centro Medico De Pr Edif. Principal Escuela De Medicina San Juan PR 00929-0134 Ph: (787) 758-2525 |
| NPI Number | 1790822641 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 12/28/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790822641 | NPI | - | NPPES |
| ---56 | Other | PPMI GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Primary |
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