Healthcare Provider Details

I. General information

NPI: 1285571323
Provider Name (Legal Business Name): PG CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 CALLE COLL Y TOSTE
SAN JUAN PR
00918-4026
US

IV. Provider business mailing address

323 CALLE COLL Y TOSTE
SAN JUAN PR
00918-4026
US

V. Phone/Fax

Practice location:
  • Phone: 939-640-4629
  • Fax:
Mailing address:
  • Phone: 939-640-4629
  • 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: PABLO CABRAL JUAN
Title or Position: CLINICAL PSYCHOLOGIST
Credential:
Phone: 939-640-4629