Healthcare Provider Details

I. General information

NPI: 1669996393
Provider Name (Legal Business Name): CARIBBEAN MHG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256 QUINTAS DE LA REINA
SAN GERMAN PR
00683
US

IV. Provider business mailing address

256 QUINTAS DE LA REINA
SAN GERMAN PR
00683
US

V. Phone/Fax

Practice location:
  • Phone: 787-399-3729
  • Fax:
Mailing address:
  • Phone: 787-399-3729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HECTOR R CABAN
Title or Position: PRESIDENT
Credential: MD
Phone: 787-399-3729