Healthcare Provider Details

I. General information

NPI: 1497681480
Provider Name (Legal Business Name): RENE ARTURO PEDRAZA ESPADA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 191688
SAN JUAN PR
00919-1688
US

IV. Provider business mailing address

381 CARR 787
CIDRA PR
00739-2258
US

V. Phone/Fax

Practice location:
  • Phone: 787-759-2121
  • Fax: 787-765-7665
Mailing address:
  • Phone: 787-759-2121
  • Fax: 787-765-7665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number9131
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: