Provider Demographics
NPI:1013573435
Name:CENTRO PSICOTERAPEUTICO CORP
Entity Type:Organization
Organization Name:CENTRO PSICOTERAPEUTICO CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROBLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-879-5550
Mailing Address - Street 1:PO BOX 141717
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614
Mailing Address - Country:US
Mailing Address - Phone:787-879-5550
Mailing Address - Fax:787-879-5550
Practice Address - Street 1:AVENIDA VICTOR ROJAS
Practice Address - Street 2:ESQUINA JUAN COLON PADILLA 19
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-879-5550
Practice Address - Fax:787-879-5550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty