Active NPI
Ileana Laracuente Rosado
- Clinical Psychologist
- Humacao, PR
National Provider Identifier
1457521684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1619
- Practice address
- Ave. Tejas 90 KM. 5
Aps Clinics PR
Humacao, PR 00791 - Phone
- (787) 641-0774
- Fax
- (787) 641-0776
- NPI assigned
- Mar 4, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1619 | PR | Primary |
Addresses
Primary practice location
Ave. Tejas 90 KM. 5
Aps Clinics PR
Humacao, PR 00791
Mailing address
PO Box 71474
Aps Healthcare PR
San Juan, PR 00936-8574
Phone (787) 641-0774
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1619 | PR | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204588800000",
"number": "1457521684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 71474",
"address_2": "APS HEALTHCARE PR",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009368574",
"telephone_number": "787-641-0774",
"fax_number": "787-641-0776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "AVE. TEJAS 90 KM. 5",
"address_2": "APS CLINICS PR",
"city": "HUMACAO",
"state": "PR",
"postal_code": "00791",
"telephone_number": "787-641-0774",
"fax_number": "787-641-0776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARACUENTE ROSADO",
"first_name": "ILEANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-04",
"last_updated": "2008-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "1619",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Humacao, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.