Provider Demographics
NPI:1013128107
Name:BAUERMEISTER, JOSE J (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:J
Last Name:BAUERMEISTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 LAS CAOBAS ST.
Mailing Address - Street 2:URB HYDE PARK
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-4230
Mailing Address - Country:US
Mailing Address - Phone:787-763-1946
Mailing Address - Fax:787-758-4561
Practice Address - Street 1:177 LAS CAOBAS ST.
Practice Address - Street 2:URN HYDE PARK
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-4230
Practice Address - Country:US
Practice Address - Phone:787-763-1946
Practice Address - Fax:787-758-4561
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR33103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical