Individual
MARIO LUIS PEREZ RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYCHOLOGIST
Contact information
Practice address
MED WELLNESS CLINIC, PD PLAZA LOCAL 3, CAGUAS, PR 00725
(787) 453-6132
Mailing address
URB.VEREDAS, #389, GURABO, PR 00778
(787) 453-6132
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3627
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3627
LISENCE
PR
Enumeration date
02/05/2010
Last updated
10/18/2010
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