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General NPI Number Information
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NPI Number | 1851695241
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Entity Type | Organization
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Legal Business Name | JOSE A. DE LEON Y ASOCIADOS, INC.
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Dates
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Enumeration Date | 12/29/2010
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Last Update Date | 12/29/2010
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Provider Practice Location Address
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Address Line | 11 CALLE FLOR GERENA N
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City | HUMACAO
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State | PR
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Zip | 00791-4288
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Country | US
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Telephone | 787-202-8547
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 715
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City | JUNCOS
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State | PR
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Zip | 00777-0715
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Country | US
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Telephone | 787-202-8547
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Fax |
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Authorized Official
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Title or Position | PSICOLOGO CLINICO
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Name | MR. JOSE A DE LEON
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Credential | PHD.
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Telephone | 787-207-8547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 1311
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 1311
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 1311
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License Number State | PR
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