Provider Demographics
NPI:1285029728
Name:OPTIMA CLINICA PSICOLOGICA, PSC.
Entity Type:Organization
Organization Name:OPTIMA CLINICA PSICOLOGICA, PSC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:ADALEE
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:787-640-2408
Mailing Address - Street 1:PO BOX 1922
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-1922
Mailing Address - Country:US
Mailing Address - Phone:787-395-7068
Mailing Address - Fax:787-395-7076
Practice Address - Street 1:K1 AVE. CASTIGLIONI
Practice Address - Street 2:URB. BAYAMON GARDENS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00967-9998
Practice Address - Country:US
Practice Address - Phone:787-395-7068
Practice Address - Fax:787-395-7076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty