MEDICARE: VIDAS EN BALANCE

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	103T00000X	Psychologist

General Provider Information

NPI Number	:	1952265266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIDAS EN BALANCE

Provider Business Mailing Address
First Line	:	445 CALLE GAVIELA
Second Line	:
City	:	ARECIBO
State	:	PR
Zip	:	00612-5974
Country	:	US
Telephone Number	:	787-374-9005
Fax Number	:

Provider Business Practice Location Address
First Line	:	LOS PINOS II
Second Line	:	G4 CALLE GAVIELA
City	:	ARECIBO
State	:	PR
Zip	:	00612-5974
Country	:	US
Telephone Number	:	787-374-9005
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENTA
Name	:	IVANYS PEREZ DELGADO
Credential	:	LIC
Telephone Number	:	787-374-9005

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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Directions to “VIDAS EN BALANCE ” Practice Location

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