NPIMap

Organization Active NPI

Clinica Interdisciplinaria del Sur Este, Inc

  • Clinical Psychologist
  • Guayama, PR
National Provider Identifier
1346626348
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2020 Issued in PR
Legal business name
CLINICA INTERDISCIPLINARIA DEL SUR ESTE, INC
Practice address
B-9 Ave Los Veteranos
Urb Villa Rosa III
Guayama, PR 00784
Phone
(787) 900-3188
NPI assigned
Aug 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Authorized official

Name
Dr. Waleska S. Pabon
Title
President
Phone
(787) 900-3188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 2020 PR Primary

Addresses

Primary practice location

B-9 Ave Los Veteranos
Urb Villa Rosa III
Guayama, PR 00784

Mailing address

PO Box 1399
Patillas, PR 00723
Phone (787) 900-3188

National Provider Directory

National Provider Directory
Tax ID family
Clinica Interdisciplinaria del Sur Este Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438560000000",
    "number": "1346626348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1399",
            "city": "PATILLAS",
            "state": "PR",
            "postal_code": "00723",
            "telephone_number": "787-900-3188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "B-9 AVE LOS VETERANOS",
            "address_2": "URB VILLA ROSA III",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "00784",
            "telephone_number": "787-900-3188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA INTERDISCIPLINARIA DEL SUR ESTE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-03",
        "status": "A",
        "authorized_official_last_name": "PABON",
        "authorized_official_first_name": "WALESKA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-900-3188",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "2020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guayama, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.