Healthcare Provider Details

I. General information

NPI: 1942418439
Provider Name (Legal Business Name): CLINICA DR. MERLOS Y ASOCIADOS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 11/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

C GUARIONEZ LOCAL 7
SAN JUAN PR
00917
US

IV. Provider business mailing address

C/ GUARIONEX LOCAL 7
SAN JUAN PR
00917
US

V. Phone/Fax

Practice location:
  • Phone: 787-281-7314
  • Fax:
Mailing address:
  • Phone: 787-281-7314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberCASM-0201
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberCASM-0201
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberCASM-0201
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberCASM-0201
License Number StatePR
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberCASM-0201
License Number StatePR

VIII. Authorized Official

Name: PASCUAL MERLOS
Title or Position: MEDICO
Credential:
Phone: 787-281-7314