Provider Demographics
NPI:1821594193
Name:PULIDO, CLARA E
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:E
Last Name:PULIDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 11
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9767
Mailing Address - Country:US
Mailing Address - Phone:787-760-0222
Mailing Address - Fax:787-708-6325
Practice Address - Street 1:9 CALLE ACUARELA
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-3504
Practice Address - Country:US
Practice Address - Phone:787-708-6323
Practice Address - Fax:787-708-6325
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR968225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor