Healthcare Provider Details

I. General information

NPI: 1306779897
Provider Name (Legal Business Name): PSICOSYNAPSE INTEGRAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 CALLE JUAN SAN ANTONIO
MOCA PR
00676-4146
US

IV. Provider business mailing address

PO BOX 1894
CAGUAS PR
00726-1894
US

V. Phone/Fax

Practice location:
  • Phone: 787-630-3052
  • Fax:
Mailing address:
  • Phone: 787-630-3052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SUSANA BERRIOS RIVERA
Title or Position: MANAGING MEMBER
Credential:
Phone: 787-630-3052