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General NPI Number Information
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NPI Number | 1033750013
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Entity Type | Organization
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Legal Business Name | DASEIN CORP
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Dates
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Enumeration Date | 10/01/2019
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Last Update Date | 10/01/2019
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Provider Practice Location Address
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Address Line | CARR 586 KM 18.8 CABO CARIBE #1783-2A
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City | VEGA BAJA
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State | PR
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Zip | 00964
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Country | US
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Telephone | 939-345-1002
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Fax | 939-345-1001
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Provider Business Mailing Address
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Address Line | P.O. BOX 1320
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City | SABANA SECA
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State | PR
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Zip | 00952
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Country | US
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Telephone | 767-364-8028
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Fax | 939-345-1001
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Authorized Official
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Title or Position | PRESIDENT, TREASURER
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Name | MR. GUSTAVO PADRON RODRIGUEZ
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Credential | PH.D.
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Telephone | 787-354-8028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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