Healthcare Provider Details

I. General information

NPI: 1245177096
Provider Name (Legal Business Name): CENTRO PSICOTERAPEUTICO TRANSFORMARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 149 KM 63.8 BO GUAYABAL GUAYABAL PROFESSIONAL BUILDING, SUITE 2005
JUANA DIAZ PR
00795
US

IV. Provider business mailing address

PO BOX 7105
PONCE PR
00732-7105
US

V. Phone/Fax

Practice location:
  • Phone: 939-380-3692
  • Fax:
Mailing address:
  • Phone: 939-380-3692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: LISANDRA MARTINEZ
Title or Position: OWNER
Credential:
Phone: 939-380-3692