MEDICARE: DR. MARIA CARMEN RESTO 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	103T00000X	Psychologist	3288	PR

General Provider Information

NPI Number	:	1164662227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA CARMEN RESTO PSY.D.

Provider Business Mailing Address
First Line	:	46 CALLE AGUADILLA
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00917-4816
Country	:	US
Telephone Number	:	787-765-6184
Fax Number	:	787-765-6184

Provider Business Practice Location Address
First Line	:	46 CALLE AGUADILLA PEREZ MORRIS
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00917-4816
Country	:	US
Telephone Number	:	787-765-6184
Fax Number	:	787-765-6184

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

Provider Enumeration Date	:	03/03/2009
Last Update Date	:	03/03/2009

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