Healthcare Provider Details

I. General information

NPI: 1588464556
Provider Name (Legal Business Name): TATIANA VILLARINY MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2025
Last Update Date: 03/18/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 366528
SAN JUAN PR
00936-6528
US

IV. Provider business mailing address

AMERICO MIRANDA AVE. PO BOX 366528
SAN JUAN PR
00936-6525
US

V. Phone/Fax

Practice location:
  • Phone: 787-754-8500
  • Fax: 787-999-0838
Mailing address:
  • Phone: 787-754-8500
  • Fax: 787-999-0838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15812
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: