Healthcare Provider Details

I. General information

NPI: 1861907396
Provider Name (Legal Business Name): TIBER HEALTH, PUBLIC BENEFIT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2017
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 CALLE DR LUIS F SALA
PONCE PR
00716
US

IV. Provider business mailing address

PO BOX 7004
PONCE PR
00732-7004
US

V. Phone/Fax

Practice location:
  • Phone: 787-840-0052
  • Fax: 787-840-2317
Mailing address:
  • Phone: 787-840-2575
  • Fax: 787-840-2317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEJANDRO RAMIREZ
Title or Position: CFO
Credential:
Phone: 877-840-2575