Healthcare Provider Details

I. General information

NPI: 1407721608
Provider Name (Legal Business Name): GLORIMAR BAEZ MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 10/07/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA LAS CUMBRES, CARRETERA 199 B-2
BAYAMON PR
00956
US

IV. Provider business mailing address

CALLE 5 AC 11 REPARTO VALENCIA
BAYAMON PR
00959
US

V. Phone/Fax

Practice location:
  • Phone: 787-608-2626
  • Fax:
Mailing address:
  • Phone: 787-226-9814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number8344
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: