Provider Demographics
NPI:1982841706
Name:INSTITUTO NEUROPSIQUIATRICO METROPOLITANO PSC
Entity Type:Organization
Organization Name:INSTITUTO NEUROPSIQUIATRICO METROPOLITANO PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF THE CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-743-3234
Mailing Address - Street 1:URB. HACIENDA SAN JOSE
Mailing Address - Street 2:749 VIA FAROLERO
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:787-746-3234
Mailing Address - Fax:787-743-3769
Practice Address - Street 1:PROFESSIONAL CENTER BUILDING
Practice Address - Street 2:MUNOZ RIVERA NO. 312
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-746-3234
Practice Address - Fax:787-743-3769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR140002084P0800X
2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty