Healthcare Provider Details

I. General information

NPI: 1093871709
Provider Name (Legal Business Name): JOSEFINA MELENDEZ CABRERO PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 AV. JUAN PONCE DE LEON SUITE 104 PROFESSIONAL MEDICAL PLAZA
SAN JUAN PR
00918
US

IV. Provider business mailing address

PO BOX 194589
SAN JUAN PR
00919-4589
US

V. Phone/Fax

Practice location:
  • Phone: 939-645-8155
  • Fax: 787-497-3478
Mailing address:
  • Phone: 939-645-8155
  • Fax: 787-497-3478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number2764
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2764
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: