MEDICARE: IRMARELIS RODRIGUEZ CALDERON MA

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	103TC1900X	Counseling Psychologist	6560	PR

General Provider Information

NPI Number	:	1558238915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRMARELIS RODRIGUEZ CALDERON MA

Provider Business Mailing Address
First Line	:	URB. VALENCIA
Second Line	:	CALLE 11 AL-13
City	:	BAYAMON
State	:	PR
Zip	:	00959-0000
Country	:	US
Telephone Number	:	787-370-5454
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 CALLE ACUARELA
Second Line	:	SUITE A-06
City	:	GUAYNABO
State	:	PR
Zip	:	00969
Country	:	US
Telephone Number	:	787-370-5454
Fax Number	:

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

Provider Enumeration Date	:	10/21/2025
Last Update Date	:	06/09/2026

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