Healthcare Provider Details

I. General information

NPI: 1548180995
Provider Name (Legal Business Name): NATALIA MEDINA SOCORRO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1349 CALLE SALUD STE 3
PONCE PR
00717-2017
US

IV. Provider business mailing address

6023 CALLE EL REYENT
PONCE PR
00728-2400
US

V. Phone/Fax

Practice location:
  • Phone: 787-840-7747
  • Fax:
Mailing address:
  • Phone: 787-640-9615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number8782
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: