MEDICARE: DR. MYRELIS APONTE-SAMALOT PSY.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	103G00000X	Clinical Neuropsychologist	2716	PR
2	103TC0700X	Clinical Psychologist	2716	PR

General Provider Information

NPI Number	:	1932306354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MYRELIS APONTE-SAMALOT PSY.D.

Provider Business Mailing Address
First Line	:	PO BOX 193891
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00919-3891
Country	:	US
Telephone Number	:	787-529-1584
Fax Number	:	148-421-0537

Provider Business Practice Location Address
First Line	:	403 CALLE DEL PARQUE
Second Line	:	5TH FLOOR
City	:	SANTURCE
State	:	PR
Zip	:	00912-3709
Country	:	US
Telephone Number	:	787-529-1584
Fax Number	:

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

Provider Enumeration Date	:	06/29/2007
Last Update Date	:	09/11/2025

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