MEDICARE: NOVAPSYCH 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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1972434728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVAPSYCH PSC

Provider Business Mailing Address
First Line	:	CENTRO SAN CRISTOBAL
Second Line	:	SUITE 207
City	:	SANTA ISABEL
State	:	PR
Zip	:	00757-0000
Country	:	US
Telephone Number	:	787-934-6833
Fax Number	:

Provider Business Practice Location Address
First Line	:	CENTRO SAN CRISTOBAL
Second Line	:	SUITE 207
City	:	SANTA ISABEL
State	:	PR
Zip	:	00757-0000
Country	:	US
Telephone Number	:	787-934-6833
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSEPH RODRIGUEZ ROCHE
Credential	:	MD
Telephone Number	:	787-709-3743

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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