Healthcare Provider Details

I. General information

NPI: 1851707673
Provider Name (Legal Business Name): PSYCHIATRICS PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7813 CALLE NAZARET URB SANTA MARIA
PONCE PR
00717-1006
US

IV. Provider business mailing address

7813 CALLE NAZARET URB SANTA MARIA
PONCE PR
00717-1006
US

V. Phone/Fax

Practice location:
  • Phone: 787-840-1053
  • Fax:
Mailing address:
  • Phone: 787-840-1053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StatePR

VIII. Authorized Official

Name: NELSON C DIAZ-BAEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 787-840-1053