MEDICARE: DENYLUZ ESCOBAR IGLESIAS

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
1	101YP2500X	Professional Counselor	4695	PR

General Provider Information

NPI Number	:	1194604959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENYLUZ ESCOBAR IGLESIAS

Provider Business Mailing Address
First Line	:	URB. COUNTRY CLUB 965 CALLE MALVIS
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00924
Country	:	US
Telephone Number	:	787-486-2979
Fax Number	:

Provider Business Practice Location Address
First Line	:	URB. COUNTRY CLUB 965 CALLE MALVIS
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00924-1758
Country	:	US
Telephone Number	:	787-486-2979
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2025
Last Update Date	:	08/27/2025

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