MEDICARE: CELMARI PEREZ ARENA M.A.

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	103TS0200X	School Psychologist	2200	PR

General Provider Information

NPI Number	:	1548388671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELMARI PEREZ ARENA M.A.

Provider Business Mailing Address
First Line	:	UNIVERSITY GARDENS 903 FORDHAM ST.
Second Line	:
City	:	RIO PIEDRAS
State	:	PR
Zip	:	00927
Country	:	US
Telephone Number	:	787-758-1376
Fax Number	:

Provider Business Practice Location Address
First Line	:	903 CALLE FORDHAM
Second Line	:	UNIVERSITY GARDENS
City	:	SAN JUAN
State	:	PR
Zip	:	00927-4816
Country	:	US
Telephone Number	:	787-758-1376
Fax Number	:

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

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	08/22/2007

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