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NPI Code Detail

MEDICARE: MRS. KEYLIVETTE ORENGO MS

MEDICARE:  MRS. KEYLIVETTE  ORENGO  MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TS0200XSchool Psychologist1699PR

General Provider Information

NPI Number : 1154892685
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KEYLIVETTE ORENGO MS
Provider Business Mailing Address
First Line : 17 COLINAS DEL SOL 1 ST 4
Second Line : APT 1711
City : BAYAMON
State : PR
Zip : 00957
Country : US
Telephone Number : 787-215-2574
Fax Number :
Provider Business Practice Location Address
First Line : 17 COLINAS DEL SOL 1 ST 4
Second Line : APT 1711
City : BAYAMON
State : PR
Zip : 00957
Country : US
Telephone Number : 787-215-2574
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2018
Last Update Date : 12/10/2018

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Directions to “ MRS. KEYLIVETTE ORENGO MS” Practice Location

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