MEDICARE: DR. MARIE RODRIGUEZ-BERTRAN PSY D

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	103T00000X	Psychologist
2	103TC0700X	Clinical Psychologist	3032	PR

General Provider Information

NPI Number	:	1619155975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIE RODRIGUEZ-BERTRAN PSY D

Provider Business Mailing Address
First Line	:	PLAZAS DE TORRIMAR 1 5109
Second Line	:	110 AVE LOS FILTROS
City	:	BAYAMON
State	:	PR
Zip	:	00959
Country	:	US
Telephone Number	:	787-557-9546
Fax Number	:

Provider Business Practice Location Address
First Line	:	1666 AVE PARANA LOCAL 202
Second Line	:	URB. EL CEREZAL
City	:	SAN JUAN
State	:	PR
Zip	:	00926-0092
Country	:	US
Telephone Number	:	787-557-9546
Fax Number	:

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

Provider Enumeration Date	:	02/08/2008
Last Update Date	:	12/12/2024

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