Carmen I. Medina Perez, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

1914 Issued in PR

Practice address

Street 1 a 4 Condado Moderno
Suite 6
Caguas, PR 00725

Phone

(787) 374-3230

NPI assigned

Jan 25, 2007

Last updated

Jun 19, 2018By the provider in NPPES

Sex

Female

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

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1801942958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "STREET 1 A 4 CONDADO MODERNO",
            "address_2": "SUITE 6",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STREET 1 A 4 CONDADO MODERNO",
            "address_2": "SUITE 6",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-374-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA PEREZ",
        "first_name": "CARMEN",
        "middle_name": "I.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PR",
            "license": "1914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medicolegal Physiatrist Services PSC
• Mediko Imaging Inc.
• Mediko Medicina Primaria Corp
• Aidelis Medina Flores
• Keishla Medina Ortiz
• Adyanis Kamyl Medina Rodriguez, RN
• Ingrid Medina Vazquez, PHARM.D.
• Agustin Medina-Rosario, M.D.
• Eily Medina
• Keishla Medina, MPHE

• Clinical Child & Adolescent Psychologist in Caguas, PR
• Providers in Caguas, PR by specialty
• Clinical Child & Adolescent Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.