MEDICARE: DR. MARIEVA PUIG PH.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	1968	PR

General Provider Information

NPI Number	:	1538265970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIEVA PUIG PH.D.

Provider Business Mailing Address
First Line	:	512 AVE ANDALUCIA STE 2A
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00920-0000
Country	:	US
Telephone Number	:	787-974-2211
Fax Number	:

Provider Business Practice Location Address
First Line	:	512 AVE ANDALUCIA STE 2A
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00920-0000
Country	:	US
Telephone Number	:	787-974-2211
Fax Number	:

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

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	05/19/2026

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