| Renacer Llc | |
|
Bo. Rosario Bajo 3 Calle Aurora Arroyo San German PR 00683 | |
| (787) 988-5100 | |
| Not Available |
| Full Name | Renacer Llc |
|---|---|
| Speciality | Psychologist |
| Location | Bo. Rosario Bajo 3 Calle Aurora Arroyo, San German, Puerto Rico |
| Authorized Official Name and Position | Alerys M De Jesus Rodriguez (PRESIDENT) |
| Authorized Official Contact | 7879885100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renacer Llc Po Box 334421 Ponce PR 00733-4421 Ph: () - | Renacer Llc Bo. Rosario Bajo 3 Calle Aurora Arroyo San German PR 00683 Ph: (787) 988-5100 |
| NPI Number | 1306416888 |
|---|---|
| Provider Enumeration Date | 06/28/2021 |
| Last Update Date | 12/28/2023 |
| Certification Date | 12/26/2023 |
| Medicare PECOS PAC ID | 1254872336 |
|---|---|
| Medicare Enrollment ID | O20240916003840 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306416888 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Alerys Marie De Jesus Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982283305 PECOS PAC ID: 2163963240 Enrollment ID: I20240916003882 |
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