Healthcare Provider Details

I. General information

NPI: 1225714827
Provider Name (Legal Business Name): ANA LIZ ADORNO LCDA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 AVE ESCORIAL
SAN JUAN PR
00920-4764
US

IV. Provider business mailing address

1247 CARR 860 APT 315
CAROLINA PR
00987-7239
US

V. Phone/Fax

Practice location:
  • Phone: 787-225-6297
  • Fax:
Mailing address:
  • Phone: 787-225-6297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number7667
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: