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General NPI Number Information
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NPI Number | 1346518404
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Entity Type | Organization
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Legal Business Name | OFICINA DR. ROBERTO REGO
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Dates
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Enumeration Date | 12/05/2011
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Last Update Date | 12/05/2011
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Provider Practice Location Address
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Address Line | 1600 RAMAL 842 APT 108
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City | SAN JUAN
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State | PR
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Zip | 00926-9648
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Country | US
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Telephone | 787-226-5931
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Fax |
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Provider Business Mailing Address
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Address Line | COND. ALTOS DE LA COLINA 1600 RAMAL 842 APT. 108
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-299-5735
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. REGO RV ROBERTO
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Credential | PHD.
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Telephone | 787-226-5931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 2080
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License Number State | PR
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