Healthcare Provider Details

I. General information

NPI: 1578448098
Provider Name (Legal Business Name): MARISABEL TROCHE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 02 BOX 2259
BOQUERON PR
00622
US

IV. Provider business mailing address

HC 02 BOX 2259
BOQUERON PR
00622
US

V. Phone/Fax

Practice location:
  • Phone: 787-318-0914
  • Fax:
Mailing address:
  • Phone: 787-318-0914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17266
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: