MEDICARE: MARIA DE LOS A BURGOS CARRION PSY.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	2942	PR

General Provider Information

NPI Number	:	1003085622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA DE LOS A BURGOS CARRION PSY.D

Provider Business Mailing Address
First Line	:	16 AVE PRINCIPAL
Second Line	:	URBANIZACION BAY VIEW
City	:	CATANO
State	:	PR
Zip	:	00962-4269
Country	:	US
Telephone Number	:	787-667-3546
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 CALLE PRINCIPAL
Second Line	:	URBANIZACION BAY VIEW
City	:	CATANO
State	:	PR
Zip	:	00962-4269
Country	:	US
Telephone Number	:	787-667-3546
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2008
Last Update Date	:	08/28/2014

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