Healthcare Provider Details

I. General information

NPI: 1699680082
Provider Name (Legal Business Name): MRS. ANYELY DEL CARMEN OTERO TOSADO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 AVE. WINSTON CHURCHILL COND. VILLAS DEL SENORIAL APT 1112
SAN JUAN PR
00926
US

IV. Provider business mailing address

60 AVE. WINSTON CHURCHILL COND. VILLAS DEL SENORIAL APT 1112
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-457-3666
  • Fax:
Mailing address:
  • Phone: 787-457-3666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number8488
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: