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General NPI Number Information
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NPI Number | 1093079980
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Entity Type | Individual
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Provider Name | DR. PABLO EDGARDO ALMODOVAR
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Gender | Male
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Dates
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Enumeration Date | 06/26/2012
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Last Update Date | 06/26/2012
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Provider Practice Location Address
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Address Line | POP-V PFIZER TOWER, 996 SAN ROBERTO ST SUITE 301
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City | SAN JUAN
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State | PR
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Zip | 00647
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Country | US
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Telephone | 787-641-0773
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Fax |
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Provider Business Mailing Address
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Address Line | 67 MONTALVA
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City | ENSENADA
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State | PR
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Zip | 00647
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Country | US
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Telephone | 787-821-0571
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 39
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License Number State | PR
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