Provider Demographics
NPI:1861282709
Name:CENTRO PSYCOLOGICO DE PUERTO RICO CORP
Entity type:Organization
Organization Name:CENTRO PSYCOLOGICO DE PUERTO RICO CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:939-437-1817
Mailing Address - Street 1:PO BOX 9121
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-9121
Mailing Address - Country:US
Mailing Address - Phone:939-437-1817
Mailing Address - Fax:939-437-1817
Practice Address - Street 1:43 CALLE FONT MARTELO
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3345
Practice Address - Country:US
Practice Address - Phone:939-437-1817
Practice Address - Fax:939-437-1817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center