Provider Demographics
NPI:1568352748
Name:SPEKTRUM GROUP LLC
Entity type:Organization
Organization Name:SPEKTRUM GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IVANELYSSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSA NEGRON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-908-3122
Mailing Address - Street 1:HC 71 BOX 3145
Mailing Address - Street 2:
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-9542
Mailing Address - Country:US
Mailing Address - Phone:787-908-3122
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA ESTATAL # 5 KM. 28.9 INTERIOR
Practice Address - Street 2:CAMINO LOS NEGRONES BO. GUADIANA
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719
Practice Address - Country:US
Practice Address - Phone:787-908-3122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities