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Contact Information

CENTRO INDIVIDUAL DE MEDICINA ESPECIALIZADA LLC
140 AVE LAS CUMBRES
GUAYNABO, PR00969-5523
 Phone: 787-731-5785
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Adolescent and Children Mental Health

261QM0855X
 

Physical Therapy

261QP2000X
 

Rehabilitation

261QR0400X B4[14] Rehabilitation Agency
Indicates primary specialty

NPI Profile & details for CENTRO INDIVIDUAL DE MEDICINA ESPECIALIZADA LLC

NPI # 1629966007
LBN Legal business name CENTRO INDIVIDUAL DE MEDICINA ESPECIALIZADA LLC
Authorized official AILED SOTO - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 06/25/2025
Last updated 06/25/2025 - About 12 months ago
Identifiers
PR Medicaid 10166
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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