Provider Demographics
NPI:1700905494
Name:CARTA-GERARDINO, MARIA VIRGINIA
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:VIRGINIA
Last Name:CARTA-GERARDINO
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 1:3944 CALLE AURORA
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1600
Mailing Address - Country:US
Mailing Address - Phone:787-840-9442
Mailing Address - Fax:
Practice Address - Street 1:3944 CALLE AURORA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1600
Practice Address - Country:US
Practice Address - Phone:787-840-9442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2733103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling