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General NPI Number Information
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NPI Number | 1245127562
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Entity Type | Individual
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Provider Name | TOMAS Y VARGAS GONZALEZ
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Gender | Male
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Dates
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Enumeration Date | 06/19/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 3 CALLE PROGRESO OFICINA 203
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City | AGUADILLA
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State | PR
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Zip | 00603-5020
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Country | US
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Telephone | 939-219-7932
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 143322
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City | ARECIBO
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State | PR
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Zip | 00614-3322
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Country | US
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Telephone | 787-669-7658
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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 | 8602
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License Number State | PR
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