Jose Pantoja

Individual provider Active NPI Marriage & Family Therapist · Vega Baja, PR

NPI 1164962452 · NPPES record last updated Mar 6, 2017

Key facts

NPI
1164962452
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
1138 (PR)
Practice address
D39 Urb Villa Real
Vega Baja, PR 00693-3980
Phone
(787) 858-2818
NPI assigned
Mar 6, 2017
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1138 PR Yes

Addresses

Primary practice location

D39 Urb Villa Real
Vega Baja, PR 00693-3980

Mailing address

D39 Urb Villa Real
Vega Baja, PR 00693-3980

Other providers in Vega Baja, PR

All providers in Vega Baja, PR · Marriage & Family Therapist in Puerto Rico

Sources for this page

Verify at the official NPI Registry.