Healthcare Provider Details

I. General information

NPI: 1952265266
Provider Name (Legal Business Name): VIDAS EN BALANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LOS PINOS II G4 CALLE GAVIELA
ARECIBO PR
00612-5974
US

IV. Provider business mailing address

445 CALLE GAVIELA
ARECIBO PR
00612-5974
US

V. Phone/Fax

Practice location:
  • Phone: 787-374-9005
  • Fax:
Mailing address:
  • Phone: 787-374-9005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: IVANYS PEREZ DELGADO
Title or Position: PRESIDENTA
Credential: LIC
Phone: 787-374-9005