Provider Demographics
NPI:1255638268
Name:MIELES DELGADO, HECTOR R (PSYD)
Entity type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:R
Last Name:MIELES DELGADO
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:PO BOX 143542
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-3542
Mailing Address - Country:US
Mailing Address - Phone:787-955-6518
Mailing Address - Fax:
Practice Address - Street 1:COND RIVERSIDE # 8
Practice Address - Street 2:SERVICIOS PSICO GERONTOLOGICOS DR. HECTOR MIELES
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7056
Practice Address - Country:US
Practice Address - Phone:787-789-8568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3907103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical