Healthcare Provider Details

I. General information

NPI: 1255240008
Provider Name (Legal Business Name): MOSAICO PSICOLOGIA Y SALUD INTEGRAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 CALLE WASHINGTON STE 306
SAN JUAN PR
00907-1562
US

IV. Provider business mailing address

3001 AVE ISLA VERDE APT 1001
CAROLINA PR
00979-4951
US

V. Phone/Fax

Practice location:
  • Phone: 939-319-8458
  • Fax:
Mailing address:
  • Phone: 787-392-7275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KEISHALEE GOMEZ
Title or Position: PRESIDENT
Credential: PHD
Phone: 787-392-7275