Provider Demographics
NPI:1851707673
Name:PSYCHIATRICS PSC
Entity Type:Organization
Organization Name:PSYCHIATRICS PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:C
Authorized Official - Last Name:DIAZ-BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-840-1053
Mailing Address - Street 1:7813 CALLE NAZARET
Mailing Address - Street 2:URB SANTA MARIA
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1006
Mailing Address - Country:US
Mailing Address - Phone:787-840-1053
Mailing Address - Fax:
Practice Address - Street 1:7813 CALLE NAZARET
Practice Address - Street 2:URB SANTA MARIA
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1006
Practice Address - Country:US
Practice Address - Phone:787-840-1053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084P0800X
PR208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty