Healthcare Provider Details

I. General information

NPI: 1821953050
Provider Name (Legal Business Name): DARYMAR VARGAS HERNANDEZ DRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 AV. TTE. CESAR LUIS GONZALEZ
SAN JUAN PR
00921
US

IV. Provider business mailing address

10 CALLE VERGEL APT 2158
CAROLINA PR
00987-7569
US

V. Phone/Fax

Practice location:
  • Phone: 787-532-0761
  • Fax:
Mailing address:
  • Phone: 787-532-0761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: