Provider Demographics
NPI:1306069323
Name:FIGUEROA, PEDRO (MA, MSW)
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:MA, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CALLE C
Mailing Address - Street 2:VILLA ORIENTE
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-3439
Mailing Address - Country:US
Mailing Address - Phone:787-295-1548
Mailing Address - Fax:787-792-7994
Practice Address - Street 1:1324 AVE FD ROOSEVELT
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-2809
Practice Address - Country:US
Practice Address - Phone:787-792-0278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5-5560Medicare ID - Type Unspecified