Provider Demographics
NPI:1366169393
Name:EQUILIBRIO, LLC.
Entity type:Organization
Organization Name:EQUILIBRIO, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSICOLOGA CLINICA
Authorized Official - Prefix:DR
Authorized Official - First Name:FABIOLA
Authorized Official - Middle Name:P
Authorized Official - Last Name:NAJUL SEDA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-360-4565
Mailing Address - Street 1:PO BOX 1868
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-1868
Mailing Address - Country:US
Mailing Address - Phone:787-624-3880
Mailing Address - Fax:
Practice Address - Street 1:CARR. 123 KM 36.6 INT 522 KM 0.2
Practice Address - Street 2:BO. GARZAS
Practice Address - City:ADJUNTAS
Practice Address - State:PR
Practice Address - Zip Code:00601-0060
Practice Address - Country:US
Practice Address - Phone:787-360-4565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1032321-0019OtherREGISTRO COMERCIANTE