Healthcare Provider Details

I. General information

NPI: 1225895477
Provider Name (Legal Business Name): CARIBEPSYCH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2024
Last Update Date: 03/04/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 CALLE DINAMARCA
SAN GERMAN PR
00683-3522
US

IV. Provider business mailing address

PO BOX 2003
SAN GERMAN PR
00683-2003
US

V. Phone/Fax

Practice location:
  • Phone: 939-228-9703
  • Fax:
Mailing address:
  • Phone: 939-228-9703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ELVIN ECHEVARRIA ROSA
Title or Position: PRESIDENT
Credential: MD
Phone: 939-228-9703