Provider Demographics
NPI:1790356608
Name:CLINICA INTEGRAL MULTIDISCIPLINARIA, LLC.
Entity Type:Organization
Organization Name:CLINICA INTEGRAL MULTIDISCIPLINARIA, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PEREZ TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:939-325-2436
Mailing Address - Street 1:HC 71 BOX 6944
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-9115
Mailing Address - Country:US
Mailing Address - Phone:787-377-9225
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA #1 KM 52.6 BARRIO BEATRIZ
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-9115
Practice Address - Country:US
Practice Address - Phone:787-377-9225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-02
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty