MEDICARE: EMBRACE THERAPY CENTER LLC

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	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1538015714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMBRACE THERAPY CENTER LLC

Provider Business Mailing Address
First Line	:	PO BOX 397
Second Line	:
City	:	MERCEDITA
State	:	PR
Zip	:	00715-0397
Country	:	US
Telephone Number	:	939-209-6009
Fax Number	:

Provider Business Practice Location Address
First Line	:	TORRE SAN CRISTOBAL
Second Line	:	SUITE 102
City	:	COTO LAUREL
State	:	PR
Zip	:	00780-2826
Country	:	US
Telephone Number	:	939-209-6009
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENTE
Name	:	NICOLE VAZQUEZ COLON
Credential	:
Telephone Number	:	939-209-6009

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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