Provider Demographics
NPI:1427207075
Name:NILDA G. MEDINA
Entity Type:Organization
Organization Name:NILDA G. MEDINA
Other - Org Name:BPS BILINGUAL PSYCHOEDUCATIONAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NILDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-762-4555
Mailing Address - Street 1:PO BOX 1773
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-1773
Mailing Address - Country:US
Mailing Address - Phone:787-762-4555
Mailing Address - Fax:
Practice Address - Street 1:CASTELLANA GARDENS CAMPO RICO AVE.
Practice Address - Street 2:R5 NUMBER 7
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-762-4555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1963261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center