Provider Demographics
NPI:1902656895
Name:CLINICA PSICOLOGICA DR HECTOR J MATINEZ CAPELLA, LLC
Entity Type:Organization
Organization Name:CLINICA PSICOLOGICA DR HECTOR J MATINEZ CAPELLA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARIO
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MSS, PHD
Authorized Official - Phone:787-632-4802
Mailing Address - Street 1:PO BOX 4249
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-4249
Mailing Address - Country:US
Mailing Address - Phone:787-882-3682
Mailing Address - Fax:
Practice Address - Street 1:47 AVE SEVERIANO CUEVAS
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-5751
Practice Address - Country:US
Practice Address - Phone:787-882-3682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)