MEDICARE: MAYLIN D GOYTIA PSYD

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	7548	PR

General Provider Information

NPI Number	:	1871333898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYLIN D GOYTIA PSYD

Provider Business Mailing Address
First Line	:	205 CALLE SAN IGNACIO
Second Line	:
City	:	JUNCOS
State	:	PR
Zip	:	00777-8624
Country	:	US
Telephone Number	:	787-458-0057
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 AVE LUIS MUNOZ MARIN
Second Line	:	QUADRANGLE MEDICAL BUILDING
City	:	CAGUAS
State	:	PR
Zip	:	00725-2403
Country	:	US
Telephone Number	:	787-595-6085
Fax Number	:

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

Provider Enumeration Date	:	05/28/2024
Last Update Date	:	04/27/2026

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