Provider Demographics
NPI:1831273838
Name:CLINICA PSIQUIATRICA DE INTEGRACION BIOPSICOSOCIAL
Entity type:Organization
Organization Name:CLINICA PSIQUIATRICA DE INTEGRACION BIOPSICOSOCIAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRY
Authorized Official - Prefix:DR
Authorized Official - First Name:REYNALDO
Authorized Official - Middle Name:J
Authorized Official - Last Name:PEREZ ALVARADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-466-8754
Mailing Address - Street 1:CALLE MEXICO #385
Mailing Address - Street 2:ROLLING HILLS
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-466-8754
Mailing Address - Fax:
Practice Address - Street 1:312 AVE DE DIEGO
Practice Address - Street 2:TORRE MUSEO SUITE 301
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00909-1756
Practice Address - Country:US
Practice Address - Phone:787-217-1337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR79961041C0700X
PR144642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty