MEDICARE: NATALIA DE LA ROSA REYES PH.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	103TC0700X	Clinical Psychologist	008701	PR

General Provider Information

NPI Number	:	1972454353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIA DE LA ROSA REYES PH.D.

Provider Business Mailing Address
First Line	:	HC 12 BOX 7393
Second Line	:
City	:	HUMACAO
State	:	PR
Zip	:	00791-9240
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 CALLE ABANICO
Second Line	:
City	:	SAN LORENZO
State	:	PR
Zip	:	00754-3303
Country	:	US
Telephone Number	:	939-687-1756
Fax Number	:

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

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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