Healthcare Provider Details

I. General information

NPI: 1194559591
Provider Name (Legal Business Name): ADRIANA ENID DELGADO TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2024
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EXT SAN ANTONIO CALLE DRAMA 2045
PONCE PR
00728
US

IV. Provider business mailing address

EXT SAN ANTONIO CALLE DRAMA 2045
PONCE PR
00728
US

V. Phone/Fax

Practice location:
  • Phone: 787-677-9303
  • Fax:
Mailing address:
  • Phone: 787-677-9303
  • 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:
Title or Position:
Credential:
Phone: