Healthcare Provider Details

I. General information

NPI: 1740426642
Provider Name (Legal Business Name): LETICIA UBINAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2008
Last Update Date: 12/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 AVE MUNOZ RIVERA CONDOMINIO DARLINGTON SUITE 1100
SAN JUAN PR
00925-2717
US

IV. Provider business mailing address

89 AVE DE DIEGO STE 105 PMB 428
SAN JUAN PR
00927-6370
US

V. Phone/Fax

Practice location:
  • Phone: 787-649-0232
  • Fax: 787-782-7263
Mailing address:
  • Phone: 787-649-0232
  • Fax: 787-782-7263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number006197
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: