Provider Demographics
NPI:1285718791
Name:DELGADO FIGUEROA, BERTIS MARIA (PHD)
Entity type:Individual
Prefix:
First Name:BERTIS
Middle Name:MARIA
Last Name:DELGADO FIGUEROA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 CARR 8177
Mailing Address - Street 2:COND. TORRE DE LOS FRAILES APT. 12-K
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-3760
Mailing Address - Country:US
Mailing Address - Phone:787-790-0904
Mailing Address - Fax:
Practice Address - Street 1:I107 AVE. ORTEGON
Practice Address - Street 2:CAPARRA GALLERY SUITE 307
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-2520
Practice Address - Country:US
Practice Address - Phone:787-378-4868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0052103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR66055941824FOtherMCS ADVANTAGE CLASSICARE