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General NPI Number Information
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NPI Number | 1124443270
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Entity Type | Individual
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Provider Name | ILCHA L. GOMILA ROMERO PH.D
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Gender | Female
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Dates
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Enumeration Date | 02/26/2014
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Last Update Date | 08/23/2019
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Provider Practice Location Address
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Address Line | 20 CALLE PINEIRO URB. PINEIRO
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | US
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Telephone | 787-637-6509
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Fax |
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Provider Business Mailing Address
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Address Line | D8 PLAZA 12 URB. CAMBRIDGE PARK
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City | SAN JUAN
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State | PR
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Zip | 00926-1450
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Country | US
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Telephone | 787-637-6509
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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 | 5459
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License Number State | PR
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