Individual provider Active NPI

Coral Perez Bermudez, LCSW

  • Clinical Social Worker
  • Mayaguez, PR
National Provider Identifier
1518749829
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15182 Issued in PR
Practice address
Val Harbour Plaza
445 Gonzalez Clemente Ave. Suite 106
Mayaguez, PR 00682-1136
Phone
(939) 239-6364
NPI assigned
Oct 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 15182 PR Primary

Addresses

Primary practice location

Val Harbour Plaza
445 Gonzalez Clemente Ave. Suite 106
Mayaguez, PR 00682-1136

Mailing address

Urb. Valle Hermoso
Calle Amapola SB-13
Hormigueros, PR 00660
Phone (939) 239-6364

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250906000875 PR Practitioner - Clinical Social Worker 1052813268 Practice locations: Mayaguez, PR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

445 Ave Gonzalez Clemente
Suite 106
Mayaguez, PR 00682-1107
Phone (939) 239-6364

SB13 Calle Amapola
Hormigueros, PR 00660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1697760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1518749829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. VALLE HERMOSO",
            "address_2": "CALLE AMAPOLA SB-13",
            "city": "HORMIGUEROS",
            "state": "PR",
            "postal_code": "00660",
            "telephone_number": "939-239-6364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VAL HARBOUR PLAZA",
            "address_2": "445 GONZALEZ CLEMENTE AVE. SUITE 106",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006821136",
            "telephone_number": "939-239-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ BERMUDEZ",
        "first_name": "CORAL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-20",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PR",
            "license": "15182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

Verify at the official NPI Registry.