Healthcare Provider Details

I. General information

NPI: 1467334334
Provider Name (Legal Business Name): PROYECTO LIBELULA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 08/13/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PARC SANTA ROSA 1951 CALLE AMBROSIO PADILLA
HATILLO PR
00659-1669
US

IV. Provider business mailing address

BARRIO PUEBLO SECTOR SANTA ROSA 1951 CALLE AMBROSIO PADILLA
HATILLO PR
00659
US

V. Phone/Fax

Practice location:
  • Phone: 939-301-2791
  • Fax:
Mailing address:
  • Phone: 939-301-2791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MARILYN SANTIAGO QUINONES
Title or Position: PSICOLOGA CLINICA
Credential: PSYD
Phone: 939-301-2791