Provider Demographics
NPI:1023535390
Name:CENTRO TERAPEUTICO MULTIDISCIPLINARIO CARI
Entity Type:Organization
Organization Name:CENTRO TERAPEUTICO MULTIDISCIPLINARIO CARI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCDO
Authorized Official - Phone:787-233-2747
Mailing Address - Street 1:100 CALLE 220 APT 109
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00982-2802
Mailing Address - Country:US
Mailing Address - Phone:787-233-2747
Mailing Address - Fax:
Practice Address - Street 1:2U5 AVE LAUREL
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-3340
Practice Address - Country:US
Practice Address - Phone:787-233-2747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-27
Last Update Date:2017-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001677103T00000X
PR2089235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty