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General NPI Number Information
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NPI Number | 1386976934
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Entity Type | Individual
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Provider Name | CARMEN M GOMEZ- MILIAN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 02/08/2010
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 201 JOSE DE DIEGO AVE. PLAZA ANGORA
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City | SAN LORENZO
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State | PR
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Zip | 00754
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Country | US
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Telephone | 787-736-4555
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Fax |
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Provider Business Mailing Address
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Address Line | URB. MANSIONES DE MONTE SERENO 29 CALLE 3
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City | SAN LORENZO
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State | PR
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Zip | 00754
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Country | US
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Telephone | 787-398-2868
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Fax | 787-736-4555
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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 | 3549
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License Number State | PR
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