Provider Demographics
NPI:1245450584
Name:NEVARES, MAYRA (PHD)
Entity type:Individual
Prefix:DR
First Name:MAYRA
Middle Name:
Last Name:NEVARES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 STREET # 1059
Mailing Address - Street 2:VILLA NEVAREZ
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-0000
Mailing Address - Country:US
Mailing Address - Phone:787-764-7402
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF PUERTO RICO MEDICAL SCIENCES CAMPUS
Practice Address - Street 2:DEPARTMENT OF PSYQUATRY 9TH FLOOR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936-5067
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:787-764-7004
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1818103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical