Healthcare Provider Details

I. General information

NPI: 1932053675
Provider Name (Legal Business Name): DORIED CARRASQUILLO PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2026
Last Update Date: 02/20/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 111 KM 47 INTERIOR BARRIO ANGELES
UTUADO PR
00611
US

IV. Provider business mailing address

PO BOX 448
UTUADO PR
00641-0448
US

V. Phone/Fax

Practice location:
  • Phone: 787-392-6461
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number008664
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: