MEDICARE: INSPIRA PSYCHIATRIC SERVICES PSC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1114972700
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSPIRA PSYCHIATRIC SERVICES PSC

Provider Business Mailing Address
First Line	:	PO BOX 367221
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00936-7221
Country	:	US
Telephone Number	:	787-753-9515
Fax Number	:	787-753-9515

Provider Business Practice Location Address
First Line	:	435 AVE HOSTOS
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3014
Country	:	US
Telephone Number	:	787-753-9515
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ALBERTO VARELA
Credential	:	MD
Telephone Number	:	787-753-9515

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	08/22/2020

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