Provider Demographics
NPI:1467673806
Name:JAVIER LAGUER, JOSE GUSTAVO (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:GUSTAVO
Last Name:JAVIER LAGUER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2304 CALLE LOMAS, URB. VALLE ALTO
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PUERTORICO
Mailing Address - Zip Code:00730
Mailing Address - Country:UM
Mailing Address - Phone:787-367-4623
Mailing Address - Fax:
Practice Address - Street 1:1665 PASEO VILLA FLORES; URB VILLA FLORES
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00716
Practice Address - Country:UM
Practice Address - Phone:1787-608-1270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2756103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical