| Psidep Llc | |
|
Moca Medical Plaza #113 Carr 110 Km 12.4 Moca PR 00676 | |
| (787) 546-7508 | |
| Not Available |
| Full Name | Psidep Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | Moca Medical Plaza #113 Carr 110 Km 12.4, Moca, Puerto Rico |
| Authorized Official Name and Position | Abdiel Muniz Vera (DIRECTOR) |
| Authorized Official Contact | 7875467508 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psidep Llc Po Box 1106 Moca PR 00676-1106 Ph: (787) 546-7508 | Psidep Llc Moca Medical Plaza #113 Carr 110 Km 12.4 Moca PR 00676 Ph: (787) 546-7508 |
| NPI Number | 1790414530 |
|---|---|
| Provider Enumeration Date | 06/07/2022 |
| Last Update Date | 06/07/2022 |
| Certification Date | 06/01/2022 |
| Medicare PECOS PAC ID | 3173909488 |
|---|---|
| Medicare Enrollment ID | O20221010001471 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790414530 | NPI | - | NPPES |
| Provider Name | Abdiel Muniz Vera |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376115295 PECOS PAC ID: 8325438112 Enrollment ID: I20211209003041 |
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