Healthcare Provider Details

I. General information

NPI: 1356557011
Provider Name (Legal Business Name): EVA Y RADINSON PEREZ RN, MA, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 12/20/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE DR BASORA 55 N EDIF MEDICO IV OFICINA 201
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

HC 61 BOX 34763
AGUADA PR
00602-9415
US

V. Phone/Fax

Practice location:
  • Phone: 787-265-5583
  • Fax:
Mailing address:
  • Phone: 787-265-5583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number25781
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3927
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: