1306494091 NPI number — SERVICIOS PSIQUIATRICOS GALATEO LLC

Table of content: (NPI 1306494091)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306494091 NPI number — SERVICIOS PSIQUIATRICOS GALATEO LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SERVICIOS PSIQUIATRICOS GALATEO LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306494091
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
SERVICIOS PSIQUIATRICOS GALATEO LLC
Provider Second Line Business Mailing Address:
URB MANSIONES 3073 CALLE MONACO C42
Provider Business Mailing Address City Name:
CABO ROJO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00623-8972
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-830-8866
Provider Business Mailing Address Fax Number:
787-830-8866

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CLINICA MEDICINA PRIMARIA
Provider Second Line Business Practice Location Address:
CARR #2 KM 112.2 BO MORA
Provider Business Practice Location Address City Name:
ISABELA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00662
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-830-8866
Provider Business Practice Location Address Fax Number:
787-830-8866
Provider Enumeration Date:
08/27/2019

Additional Information

Authorized Official

Authorized Official Last Name:
VELEZ GONZALEZ
Authorized Official First Name:
PEDRO
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-830-8866

Provider Taxonomy Codes

  • Taxonomy code: 261QC1800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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