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General NPI Number Information
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NPI Number | 1629606611
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Entity Type | Individual
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Provider Name | DR. EDUIN ELADIO CACERES ORTIZ
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Gender | Male
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 1479 AVE ASHFORD STE 6
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City | SAN JUAN
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State | PR
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Zip | 00907-1583
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Country | US
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Telephone | 787-513-3055
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CALLE POPPY APT B2 URB. PARQUE FORESTAL
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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 | 787-513-3055
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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 | 6184
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License Number State | PR
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