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NPI Code Detail

MEDICARE: MICHELLE I NAZARIO

MEDICARE: MICHELLE I NAZARIO
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
1103TC1900XCounseling Psychologist8212PR

General Provider Information

NPI Number : 1972310720
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE I NAZARIO
Provider Business Mailing Address
First Line : BO EL DUQUE BUZON 1961
Second Line :
City : NAGUABO
State : PR
Zip : 00718
Country : US
Telephone Number : 787-307-8285
Fax Number :
Provider Business Practice Location Address
First Line : SAN ALFONSO D12 CALLE MIS AMORES
Second Line :
City : CAGUAS
State : PR
Zip : 00725-5821
Country : US
Telephone Number : 787-930-3144
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2024
Last Update Date : 01/17/2025

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