Healthcare Provider Details

I. General information

NPI: 1861860397
Provider Name (Legal Business Name): SPECIAL NEEDS SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2015
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 AVE. HOSTOS MEDICAL CENTER PLAZA SUITE #316
MAYAGUEZ PR
00682-1541
US

IV. Provider business mailing address

740 AVE. HOSTOS MEDICAL CENTER PLAZA SUITE #316
MAYAGUEZ PR
00682-1541
US

V. Phone/Fax

Practice location:
  • Phone: 787-454-6966
  • Fax: 787-476-8020
Mailing address:
  • Phone: 787-454-6966
  • Fax: 787-476-8020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number328161
License Number StatePR

VIII. Authorized Official

Name: JONATHAN RODRIGUEZ SOTO
Title or Position: PRESIDENT
Credential: OT
Phone: 787-454-6966