| Programa De Servicios De Salud En El Hogar Y Hospicio San Lucas, Inc | |
|
Parking Centro Medico Plaza Central Local #9 2nd Piso Rio Piedras PR 00927 | |
| (787) 843-4185 | |
| Not Available |
| Full Name | Programa De Servicios De Salud En El Hogar Y Hospicio San Lucas, Inc |
|---|---|
| Speciality | Psychologist |
| Location | Parking Centro Medico Plaza Central, Rio Piedras, Puerto Rico |
| Authorized Official Name and Position | Isuanet Castillo Medina (DIRECTORE EXECUTIVA OPERACIONAL) |
| Authorized Official Contact | 7878434185 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Programa De Servicios De Salud En El Hogar Y Hospicio San Lucas, Inc Po Box 7064 Ponce PR 00732-7064 Ph: (787) 843-4185 | Programa De Servicios De Salud En El Hogar Y Hospicio San Lucas, Inc Parking Centro Medico Plaza Central Local #9 2nd Piso Rio Piedras PR 00927 Ph: (787) 843-4185 |
| NPI Number | 1023729266 |
|---|---|
| Provider Enumeration Date | 12/08/2022 |
| Last Update Date | 12/08/2022 |
| Certification Date | 11/21/2022 |
| Medicare PECOS PAC ID | 3678957461 |
|---|---|
| Medicare Enrollment ID | O20230225000069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023729266 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | (* (Not Available)) | Primary |
| Provider Name | Enid M Lopez Valentin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619160231 PECOS PAC ID: 3779956560 Enrollment ID: I20230225000111 |
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