Healthcare Provider Details

I. General information

NPI: 1720999089
Provider Name (Legal Business Name): METAMORPHOSIS THERAPY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 C 1 PARCELA BO NAVARRO-PARC VIEJAS
GURABO PR
00778
US

IV. Provider business mailing address

HC 3 BOX 80821
LAS PIEDRAS PR
00771-9410
US

V. Phone/Fax

Practice location:
  • Phone: 787-390-8090
  • Fax:
Mailing address:
  • Phone: 787-390-8090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JENN M SANTIAGO NIEVES
Title or Position: PRESIDENTE
Credential:
Phone: 787-208-8632