NPIMap

Organization Active NPI

Clinica Interdisciplinaria del Sureste, Inc.

  • Psychologist
  • Guayama, PR
National Provider Identifier
1407222383
Registry record updated Aug 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2020 Issued in PR
Legal business name
CLINICA INTERDISCIPLINARIA DEL SURESTE, INC.
Practice address
3 Ave. Los Veteranos
Viila Rosa B9
Guayama, PR 00728-1399
Phone
(787) 900-3188
Fax
(787) 866-0984
NPI assigned
Aug 14, 2015
Last updated
Aug 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2015

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

Authorized official

Name
Miss Waleska S. Pabon, PSY D
Title
Owner
Phone
(787) 900-3188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2020 PR Primary

Addresses

Primary practice location

3 Ave. Los Veteranos
Viila Rosa B9
Guayama, PR 00728-1399

Mailing address

PO Box 1399
Patillas, PR 00723-1399
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.

Locations

3 Ave Los Veteranos
#B9
Guayama, PR 00784
Phone (787) 900-3188

NPI Registry JSON

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

{
    "created_epoch": "1439510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439510400000",
    "number": "1407222383",
    "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": "007231399",
            "telephone_number": "787-900-3188",
            "fax_number": "787-866-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 AVE. LOS VETERANOS",
            "address_2": "VIILA ROSA B9",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "007281399",
            "telephone_number": "787-900-3188",
            "fax_number": "787-866-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA INTERDISCIPLINARIA DEL SURESTE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-14",
        "last_updated": "2015-08-14",
        "status": "A",
        "authorized_official_last_name": "PABON",
        "authorized_official_first_name": "WALESKA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-900-3188",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "PSY D"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "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 14, 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.