Healthcare Provider Details

I. General information

NPI: 1407482789
Provider Name (Legal Business Name): CLINICA DE SERVICIOS INTEGRADOS RESPIRA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2020
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

J1 CALLE 12
CAGUAS PR
00725-2098
US

IV. Provider business mailing address

20 AVE LUIS MUNOZ MARIN
CAGUAS PR
00725-1956
US

V. Phone/Fax

Practice location:
  • Phone: 787-980-5606
  • Fax:
Mailing address:
  • Phone: 787-502-0773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. NANCY I MERCED
Title or Position: CLINICA PSYCHOLOGY
Credential: PHD
Phone: 787-502-0773