| Servicios Psicologicos Renuevate Llc | |
|
Carr. 198 Km 22.0 Bo. Montones I Las Piedras PR 00771-0198 | |
| (787) 716-0050 | |
| Not Available |
| Full Name | Servicios Psicologicos Renuevate Llc |
|---|---|
| Speciality | Psychologist |
| Location | Carr. 198 Km 22.0, Las Piedras, Puerto Rico |
| Authorized Official Name and Position | Bernardo Roque (PSY.D.) |
| Authorized Official Contact | 7876452587 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Servicios Psicologicos Renuevate Llc Urb. Alturas De San Benito Calle Reina De La Paz 11 Humacao PR 00791-9202 Ph: (787) 645-2587 | Servicios Psicologicos Renuevate Llc Carr. 198 Km 22.0 Bo. Montones I Las Piedras PR 00771-0198 Ph: (787) 716-0050 |
| NPI Number | 1891518189 |
|---|---|
| Provider Enumeration Date | 11/05/2024 |
| Last Update Date | 11/05/2024 |
| Certification Date | 11/02/2024 |
| Medicare PECOS PAC ID | 6204365059 |
|---|---|
| Medicare Enrollment ID | O20250124000081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891518189 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Bernardo Roque |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295991578 PECOS PAC ID: 3274777305 Enrollment ID: I20210126002498 |
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