Healthcare Provider Details

I. General information

NPI: 1922915891
Provider Name (Legal Business Name): PUEDO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 CALLE COLOMER SANCHEZ
UTUADO PR
00641-2846
US

IV. Provider business mailing address

URB COSTA NORTE 226
HATILLO PR
00659-0000
US

V. Phone/Fax

Practice location:
  • Phone: 787-382-8992
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: WANDA I IZQUIERDO VALLE
Title or Position: PISCOLOGA
Credential: PSYD
Phone: 787-310-5821