Provider Demographics
NPI:1215063623
Name:INSTITUTO NEUROPSIQUIATRICO DE PR
Entity type:Organization
Organization Name:INSTITUTO NEUROPSIQUIATRICO DE PR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:787-751-2727
Mailing Address - Street 1:M S C 638 89 AVENIDA DE DIEGO
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6346
Mailing Address - Country:UM
Mailing Address - Phone:787-751-2727
Mailing Address - Fax:787-751-3633
Practice Address - Street 1:1580 CALLE CAVALIERI
Practice Address - Street 2:URBANIZACION CARIBE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-6115
Practice Address - Country:US
Practice Address - Phone:787-751-2727
Practice Address - Fax:787-751-3633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6011273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit