Healthcare Provider Details

I. General information

NPI: 1467578765
Provider Name (Legal Business Name): PSYCHIATRIC ASSOCIATES PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 59 BOX 6879 BO. NARANJO
AGUADA PR
00602-9669
US

IV. Provider business mailing address

HC 59 BOX 6879 BO. NARANJO
AGUADA PR
00602-9669
US

V. Phone/Fax

Practice location:
  • Phone: 787-252-9999
  • Fax:
Mailing address:
  • Phone: 787-252-9999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number15128
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number15128
License Number StatePR

VIII. Authorized Official

Name: DR. JOSE F ESPAILLAT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-252-9999