Provider Demographics
NPI:1467578765
Name:PSYCHIATRIC ASSOCIATES PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:PSYCHIATRIC ASSOCIATES PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:F
Authorized Official - Last Name:ESPAILLAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-252-9999
Mailing Address - Street 1:HC 59 BOX 6879
Mailing Address - Street 2:BO. NARANJO
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-9669
Mailing Address - Country:US
Mailing Address - Phone:787-252-9999
Mailing Address - Fax:
Practice Address - Street 1:HC 59 BOX 6879
Practice Address - Street 2:BO. NARANJO
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-9669
Practice Address - Country:US
Practice Address - Phone:787-252-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15128261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Not Answered261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health