Healthcare Provider Details

I. General information

NPI: 1306494091
Provider Name (Legal Business Name): SERVICIOS PSIQUIATRICOS GALATEO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2019
Last Update Date: 11/13/2020
Certification Date: 11/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CLINICA MEDICINA PRIMARIA CARR #2 KM 112.2 BO MORA
ISABELA PR
00662
US

IV. Provider business mailing address

SERVICIOS PSIQUIATRICOS GALATEO LLC URB MANSIONES 3073 CALLE MONACO C42
CABO ROJO PR
00623-8972
US

V. Phone/Fax

Practice location:
  • Phone: 787-830-8866
  • Fax: 787-830-8866
Mailing address:
  • Phone: 787-830-8866
  • Fax: 787-830-8866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PEDRO L VELEZ GONZALEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 787-830-8866