Healthcare Provider Details

I. General information

NPI: 1871412148
Provider Name (Legal Business Name): KAROL M OCASIO GUTIERREZ M. ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1349 CALLE SALUD STE 3
PONCE PR
00717-2017
US

IV. Provider business mailing address

4157 AVE CONSTANCIA
PONCE PR
00716-2100
US

V. Phone/Fax

Practice location:
  • Phone: 787-840-7747
  • Fax:
Mailing address:
  • Phone: 939-904-6447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number8805
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: