Healthcare Provider Details

I. General information

NPI: 1043127723
Provider Name (Legal Business Name): ESAPALABRARANDO ESPACIO CLINICO CSP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 AVE DOMENECH STE 3C-3D
SAN JUAN PR
00918-3528
US

IV. Provider business mailing address

D4 CALLE 7 URB. PARQUE DE TORRIMAR
BAYAMON PR
00959
US

V. Phone/Fax

Practice location:
  • Phone: 787-359-8694
  • Fax:
Mailing address:
  • Phone: 787-359-8694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ELISABET AVILES
Title or Position: PRESIDENT
Credential: PHD
Phone: 787-359-8694