Healthcare Provider Details

I. General information

NPI: 1194604959
Provider Name (Legal Business Name): DENYLUZ ESCOBAR IGLESIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. COUNTRY CLUB 965 CALLE MALVIS
SAN JUAN PR
00924-1758
US

IV. Provider business mailing address

URB. COUNTRY CLUB 965 CALLE MALVIS
SAN JUAN PR
00924
US

V. Phone/Fax

Practice location:
  • Phone: 787-486-2979
  • Fax:
Mailing address:
  • Phone: 787-486-2979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4695
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: