Healthcare Provider Details

I. General information

NPI: 1053703140
Provider Name (Legal Business Name): SOPHIA PINEIRO MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2015
Last Update Date: 02/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 ITURREGUI PLAZA INFANTERIA SUITE 217-A
SAN JUAN PR
00924
US

IV. Provider business mailing address

1432 BARRACUDA ST BAHIA VISTAMAR
CAROLINA PR
00983-1452
US

V. Phone/Fax

Practice location:
  • Phone: 787-701-2626
  • Fax: 787-768-8094
Mailing address:
  • Phone: 787-701-2626
  • Fax: 787-768-8094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12920
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: