Healthcare Provider Details

I. General information

NPI: 1477480770
Provider Name (Legal Business Name): INSTITUTO DE BIENESTAR ESPECIALIZADO EN TRAUMA PSICOLOGICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1479 AVE ASHFORD STE 6
SAN JUAN PR
00907-1583
US

IV. Provider business mailing address

B2 CALLE POPPY
SAN JUAN PR
00926-6559
US

V. Phone/Fax

Practice location:
  • Phone: 787-429-1325
  • Fax:
Mailing address:
  • Phone: 787-429-1325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. EDUIN ELADIO CACERES ORTIZ
Title or Position: CLINICAL PSYCHOLOGIST & CEO
Credential: PHD
Phone: 939-429-1325