Provider Demographics
NPI:1669224200
Name:SERVICIOS CLINICOS INTERDISCIPLINARIOS LLC
Entity type:Organization
Organization Name:SERVICIOS CLINICOS INTERDISCIPLINARIOS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GIOVANNI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALOMAR SASTRE
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:939-835-7173
Mailing Address - Street 1:1013 CALLE LOS FLAMBOYANES
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2240
Mailing Address - Country:US
Mailing Address - Phone:939-835-7173
Mailing Address - Fax:
Practice Address - Street 1:3020 AVE SAN CRISTOBAL
Practice Address - Street 2:
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2896
Practice Address - Country:US
Practice Address - Phone:939-835-7173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty