MEDICARE: YADIRA PEREZ MANGUAL

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	101YM0800X	Mental Health Counselor	004779	PR
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	ATAC-200-1-8563	PR

General Provider Information

NPI Number	:	1710860218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YADIRA PEREZ MANGUAL

Provider Business Mailing Address
First Line	:	URB. VALLE HERMOSO ABAJO
Second Line	:	CALLE AMAPOLA SN18
City	:	HORMIGUEROS
State	:	PR
Zip	:	00660-1304
Country	:	US
Telephone Number	:	787-306-8825
Fax Number	:

Provider Business Practice Location Address
First Line	:	CARRETERA 2 KM 157.9
Second Line	:	BARRIO SABALOS NUEVOS
City	:	MAYAGUEZ
State	:	PR
Zip	:	00682-1522
Country	:	US
Telephone Number	:	787-306-8825
Fax Number	:

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

Provider Enumeration Date	:	07/30/2025
Last Update Date	:	01/27/2026

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Directions to “ YADIRA PEREZ MANGUAL ” Practice Location

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