| Elders Of Puerto Rico, Psc | |
|
368 Calle De Diego Apt 602 San Juan PR 00923-2928 | |
| (787) 753-0663 | |
| Not Available |
| Full Name | Elders Of Puerto Rico, Psc |
|---|---|
| Speciality | Clinic/Center |
| Location | 368 Calle De Diego Apt 602, San Juan, Puerto Rico |
| Authorized Official Name and Position | Edesther Alejandra Caballero-gippson (DRA) |
| Authorized Official Contact | 7875306633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elders Of Puerto Rico, Psc 368 Calle De Diego Apt 602 San Juan PR 00923-2928 Ph: (787) 753-0663 | Elders Of Puerto Rico, Psc 368 Calle De Diego Apt 602 San Juan PR 00923-2928 Ph: (787) 753-0663 |
| NPI Number | 1225541949 |
|---|---|
| Provider Enumeration Date | 11/16/2017 |
| Last Update Date | 04/02/2018 |
| Medicare PECOS PAC ID | 8123360088 |
|---|---|
| Medicare Enrollment ID | O20190425002261 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225541949 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 3988 (Puerto Rico) | Primary |
| Provider Name | Edesther Alejandra Caballero-gippson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194011452 PECOS PAC ID: 5193996304 Enrollment ID: I20110920000540 |
| Provider Name | Lauramar Santa |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1548592595 PECOS PAC ID: 6002061306 Enrollment ID: I20130312000121 |
| Provider Name | Hector L. Rivera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730423245 PECOS PAC ID: 6800257411 Enrollment ID: I20230731000092 |
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