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General NPI Number Information
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NPI Number | 1851095947
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Entity Type | Individual
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Provider Name | JULIANA BROCO ORTIZ MS
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Gender | Female
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Dates
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Enumeration Date | 03/30/2023
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | URB LAS COLINAS VEREDA DE LA ESPINOSA APT B-103
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City | VEGA ALTA
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State | PR
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Zip | 00692
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Country | US
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Telephone | 787-204-1617
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Fax |
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Provider Business Mailing Address
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Address Line | URB LAS COLINAS 36 VEREDA DE LA ESPINOSA
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City | VEGA ALTA
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State | PR
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Zip | 00692
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Country | US
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Telephone | 787-204-1617
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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 | 7122
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License Number State | PR
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