MEDICARE: JEANNETTE ALEJANDRO

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	6015	PR

General Provider Information

NPI Number	:	1336616861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNETTE ALEJANDRO

Provider Business Mailing Address
First Line	:	URB VILLA BORINQUEN
Second Line	:	D15 CALLE YAGUEZ
City	:	CAGUAS
State	:	PR
Zip	:	00725
Country	:	US
Telephone Number	:	787-242-0876
Fax Number	:

Provider Business Practice Location Address
First Line	:	URB SANTIAGO IGLESIAS
Second Line	:	1436 AVE PAZ GRANELA
City	:	SAN JUAN
State	:	PR
Zip	:	00921
Country	:	US
Telephone Number	:	787-242-0876
Fax Number	:

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

Provider Enumeration Date	:	11/02/2018
Last Update Date	:	04/30/2024

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Directions to “ JEANNETTE ALEJANDRO ” Practice Location

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