Otto Agustin Berdiel, MS

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

831 Issued in PR

Practice address

1801 Ave Ponce de Leon Ste 411
San Juan, PR 00909-1917

Phone

(787) 509-6100

Fax

(787) 292-0521

NPI assigned

Aug 4, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1629952478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 VIA ROMA",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009766105",
            "telephone_number": "787-509-6100",
            "fax_number": "787-292-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 AVE PONCE DE LEON STE 411",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009091917",
            "telephone_number": "787-509-6100",
            "fax_number": "787-292-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERDIEL",
        "first_name": "OTTO",
        "middle_name": "AGUSTIN",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oscar Rafael Benitez, MD
• Moises Benmaman Garzon, MD
• Oliva E Benmaman, MD
• Bepresent LLC
• Pedro Federico Berdeguer-de Leon, M.D.
• Roberto Berdiel, D.M.D.
• Michael Beretta
• Raquel Ita Berezdivin, PA-C
• Jadailine Bermudez Santos
• Ramon H Bermudez-del Valle, MD

• Clinical Psychologist in San Juan, PR
• Providers in San Juan, 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 Aug 4, 2025; 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.