Healthcare Provider Details

I. General information

NPI: 1205232972
Provider Name (Legal Business Name): PSYCHIATRY SOLUTIONS GROUP P.S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2014
Last Update Date: 06/10/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BAYAMON MEDICAL PLAZA SUITE 309
BAYAMON PR
00959-7200
US

IV. Provider business mailing address

PO BOX 2278
BAYAMON PR
00960-2278
US

V. Phone/Fax

Practice location:
  • Phone: 787-379-7533
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number18745
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number18745
License Number StatePR

VIII. Authorized Official

Name: DR. MARICARMEN LOPEZ MALDONADO
Title or Position: PSYCHIATRIC
Credential: MD
Phone: 787-379-7533