Healthcare Provider Details

I. General information

NPI: 1609740604
Provider Name (Legal Business Name): SOCIEDAD PRO HOSPITAL DEL NINO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 CARR 19
GUAYNABO PR
00966-2720
US

IV. Provider business mailing address

PO BOX 1585
OROCOVIS PR
00720-1585
US

V. Phone/Fax

Practice location:
  • Phone: 787-783-2226
  • Fax:
Mailing address:
  • Phone: 787-783-2226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MS. CARLA MARIE HERNANDEZ
Title or Position: PSICOLOGA ESCOLAR
Credential: MS
Phone: 787-483-4697