Healthcare Provider Details

I. General information

NPI: 1033061114
Provider Name (Legal Business Name): JULIAN ALBERTO BURGOS RIVERA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 02/11/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 819 KM HM 1 BO BUCARABONES
TOA ALTA PR
00953
US

IV. Provider business mailing address

PO BOX 661
VEGA ALTA PR
00692-0661
US

V. Phone/Fax

Practice location:
  • Phone: 939-260-4882
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: