Active NPI
Maria de Los Angeles Balzac, M.D.
- Psychiatry Physician
- San Juan, PR
National Provider Identifier
1033120647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 12626
- Practice address
- VA Caribbean Health Center -Psych Dept.
10 Casia St.
San Juan, PR 00921-3201 - Phone
- (787) 758-7575
- NPI assigned
- Aug 10, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 12626 | PR | Primary |
Addresses
Primary practice location
VA Caribbean Health Center -Psych Dept.
10 Casia St.
San Juan, PR 00921-3201
Mailing address
Hacienda Real #253
Lluvia de Coral St.
Carolina, PR 00987
Phone (787) 769-9903
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12626 | PR | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033120647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HACIENDA REAL #253",
"address_2": "LLUVIA DE CORAL ST.",
"city": "CAROLINA",
"state": "PR",
"postal_code": "00987",
"telephone_number": "787-769-9903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "VA CARIBBEAN HEALTH CENTER -PSYCH DEPT.",
"address_2": "10 CASIA ST.",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009213201",
"telephone_number": "787-758-7575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALZAC",
"first_name": "MARIA DE LOS ANGELES",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PR",
"license": "12626",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.