Healthcare Provider Details

I. General information

NPI: 1871427922
Provider Name (Legal Business Name): ROSANGEL ROSARIO REYES JR.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 CALLE ESCUTE
JUNCOS PR
00777-3417
US

IV. Provider business mailing address

HC 12 BOX 7318
HUMACAO PR
00791-9220
US

V. Phone/Fax

Practice location:
  • Phone: 787-561-3582
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number9180
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: