Provider Demographics
NPI:1902964760
Name:OPCIONES PSICOEDUCATIVAS
Entity Type:Organization
Organization Name:OPCIONES PSICOEDUCATIVAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:VIRGILIO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-265-5583
Mailing Address - Street 1:PO BOX 6366
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-6366
Mailing Address - Country:US
Mailing Address - Phone:787-265-5583
Mailing Address - Fax:787-265-8145
Practice Address - Street 1:CALLE DR BASORA #55 N
Practice Address - Street 2:MEDICA IV BLDG OFICE 201
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-265-5583
Practice Address - Fax:787-265-8145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty