Healthcare Provider Details

I. General information

NPI: 1932306354
Provider Name (Legal Business Name): MYRELIS APONTE-SAMALOT PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 CALLE DEL PARQUE 5TH FLOOR
SANTURCE PR
00912-3709
US

IV. Provider business mailing address

PO BOX 193891
SAN JUAN PR
00919-3891
US

V. Phone/Fax

Practice location:
  • Phone: 787-529-1584
  • Fax:
Mailing address:
  • Phone: 787-529-1584
  • Fax: 148-421-0537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number2716
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2716
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: