Healthcare Provider Details

I. General information

NPI: 1558227512
Provider Name (Legal Business Name): BIOMENTAL OF PUERTO RICO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 AVE FRANKLIN D ROOSEVELT STE 1214
SAN JUAN PR
00918-8001
US

IV. Provider business mailing address

PO BOX 51507
JACKSONVILLE BEACH FL
32240-1507
US

V. Phone/Fax

Practice location:
  • Phone: 787-990-9198
  • Fax: 904-853-5885
Mailing address:
  • Phone: 904-853-5859
  • Fax: 904-853-5885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALINA MARIA GALLIANO-PARDO
Title or Position: MEDICAL DIRECTOR/MD
Credential: MD
Phone: 904-853-5859