Organization
PSICSUR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE ANGEL GANDIA PH.D. CLINICAL PSY. (COORDINADOR GENERAL)
(787) 485-6348
Entity
Organization
Contact information
Practice address
9140 CALLE MARINA, SUITE 502, PONCE, PR 00717
(787) 485-6348
Mailing address
9140 CALLE MARINA, SUITE 502, PONCE, PR 00717
(787) 485-6348
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
3500
PR
Other
Enumeration date
02/08/2012
Last updated
02/08/2012
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