Provider Demographics
NPI:1295978674
Name:MATEO-GARCIA, RAFAEL III (PHD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:
Last Name:MATEO-GARCIA
Suffix:III
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 1:14203 URB SERENNA
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-3329
Mailing Address - Country:US
Mailing Address - Phone:787-922-1698
Mailing Address - Fax:787-961-6501
Practice Address - Street 1:URB SERENNA EDIF N
Practice Address - Street 2:SUITE 302
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-922-1698
Practice Address - Fax:787-961-6501
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2268103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling