Individual provider Active NPI

Maribella Gonzalez-Viruet, PHD

  • Clinical Neuropsychologist
  • San Juan, PR
National Provider Identifier
1710231444
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
2114 Issued in PR
Practice address
1788 Calle Julio Aybar
San Juan, PR 00921-4410
Phone
(787) 638-3520
NPI assigned
Nov 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2114 PR
Clinical Neuropsychologist 103G00000X 2114 PR Primary

Addresses

Primary practice location

1788 Calle Julio Aybar
San Juan, PR 00921-4410

Mailing address

3011 Alejadrino Ave
Cond. View Point Apt 504
Guaynabo, PR 00969
Phone (787) 638-3520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2114PRMDLaboratory Management Specialist/Technologist

NPI Registry JSON

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

{
    "created_epoch": "1351814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1710231444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 ALEJADRINO AVE",
            "address_2": "COND. VIEW POINT APT 504",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-638-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1788 CALLE JULIO AYBAR",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009214410",
            "telephone_number": "787-638-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ-VIRUET",
        "first_name": "MARIBELLA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-02",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "2114",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PR",
            "license": "2114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.