Healthcare Provider Details

I. General information

NPI: 1871709121
Provider Name (Legal Business Name): VILMA M FIGUEROA-MARTINEZ M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CALLE CERRA CDT GUALBERTO RABELL
SAN JUAN PR
00907-5104
US

IV. Provider business mailing address

PO BOX 193818
SAN JUAN PR
00919-3818
US

V. Phone/Fax

Practice location:
  • Phone: 787-721-3220
  • Fax: 787-721-3207
Mailing address:
  • Phone: 787-756-8437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1466
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: