Healthcare Provider Details

I. General information

NPI: 1548388671
Provider Name (Legal Business Name): CELMARI PEREZ ARENA M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 08/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 CALLE FORDHAM UNIVERSITY GARDENS
SAN JUAN PR
00927-4816
US

IV. Provider business mailing address

UNIVERSITY GARDENS 903 FORDHAM ST.
RIO PIEDRAS PR
00927
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-1376
  • Fax:
Mailing address:
  • Phone: 787-758-1376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number2200
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: