Healthcare Provider Details

I. General information

NPI: 1003742693
Provider Name (Legal Business Name): REFLEJOS DEL INTERIOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 CALLE GAUTIER BENITEZ
CAGUAS PR
00725-4168
US

IV. Provider business mailing address

414 CALLE ALMENDRO
CAGUAS PR
00725-7525
US

V. Phone/Fax

Practice location:
  • Phone: 787-371-7680
  • Fax:
Mailing address:
  • Phone: 787-371-7680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: NICOLE MARIE DIAZ
Title or Position: PSICOLOGA
Credential:
Phone: 787-371-7680