Suilariam Cepeda Fax, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6751 Issued in PR

Practice address

30 Calle Hortencia
Carolina, PR 00987-2203

Phone

(787) 387-6603

NPI assigned

Feb 21, 2023

Last updated

Feb 22, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Salud Vida & Bienestar LLC

  • Clinical Psychologist
  • San Juan, PR
  • NPI 1831085943
  Medicare reassignment NPD
• Neurodiversamente LLC

  • Clinical Psychologist
  • San Juan, PR
  • NPI 1619862521
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1295433977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CALLE HORTENCIA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009872203",
            "telephone_number": "787-387-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CALLE HORTENCIA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009872203",
            "telephone_number": "787-387-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEPEDA FAX",
        "first_name": "SUILARIAM",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "6751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6751",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Centro Radiodiagnostico de Carolina LLC
• Centro Terapeutico Vimar, PSC
• Centro Tratamiento Ambulatorio Carolina
• Centro-Gineco Obstetrico Dr Luis E. Vazquez Zayas C.S.P.
• Keyla J Cepeda Escalera, PSYD
• John Anthony Cerda de Jesus, LIC
• Herman J Cestero Jr., M.D.
• Cfse
• Brenda E Chaar, M.D.
• Agnes Charles Torres, MD

• Clinical Psychologist in Carolina, PR
• Providers in Carolina, PR by specialty
• Clinical Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.