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General NPI Number Information
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NPI Number | 1508779471
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Entity Type | Individual
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Provider Name | NIKOL DENISSE MATOS MSW
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Gender | Female
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Dates
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Enumeration Date | 09/23/2026
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Last Update Date | 09/23/2026
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Provider Practice Location Address
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Address Line | CARR. #5 AVE. CENTRAL JUANITA FINAL
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City | BAYAMON
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State | PR
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Zip | 00960
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Country | US
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Telephone | 939-225-2400
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Fax |
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Provider Business Mailing Address
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Address Line | PALACIOS DEL MONTE 1574 CALLE MAKALU E15
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City | TOA ALTA
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State | PR
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Zip | 00953
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Country | US
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Telephone | 787-242-8238
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 13545
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License Number State | PR
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