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NPI 1467183335

NPI 1467183335 : MARANGELIE ROJAS GAGO MS : SAN JUAN, PR

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General NPI Number Information
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    NPI Number           |    1467183335
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    Entity Type          |    Individual 
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    Provider Name        |    MARANGELIE ROJAS GAGO MS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/22/2022
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    Last Update Date     |    06/22/2022
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Provider Practice Location Address
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    Address Line         |    CENTRO TERCERA ONDA AVENIDA PARANA # 22-46
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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            |    787-510-9032
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    RR 18 BOX 780A 
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    City                 |    SAN JUAN
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    State                |    PR
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    Zip                  |    00926-9923
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    Country              |    US
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    Telephone            |    787-644-2184
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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        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    6898
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    License Number State |    PR
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