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General NPI Number Information
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NPI Number | 1154532505
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Entity Type | Organization
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Legal Business Name | SERVICIOS PSIQUIATRICOS DR. RICARDO DIEZ DELGADO, CSP
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 124 WINSTON CHURCHILL ESQ. PARANA, PISO 2, OFIC. 5
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City | SAN JUAN
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State | PR
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Zip | 00936-3603
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Country | US
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Telephone | 787-763-1816
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Fax | 787-282-8424
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Provider Business Mailing Address
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Address Line | PO BOX 363603
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City | SAN JUAN
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State | PR
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Zip | 00936-3603
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Country | US
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Telephone | 787-763-1816
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Fax | 787-282-8424
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICARDO DIEZ-DELGADO
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Credential | MD
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Telephone | 787-763-1816
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 9226
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License Number State | PR
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