Healthcare Provider Details

I. General information

NPI: 1386570448
Provider Name (Legal Business Name): DENID BERDIEL ROSA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1137 CALLE K
GUAYNABO PR
00969-3557
US

IV. Provider business mailing address

1137 CALLE K
GUAYNABO PR
00969-3557
US

V. Phone/Fax

Practice location:
  • Phone: 787-941-4025
  • Fax:
Mailing address:
  • Phone: 787-941-4025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number8986
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: