Healthcare Provider Details

I. General information

NPI: 1487405627
Provider Name (Legal Business Name): BIENESTAR POSITIVO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 165 URB VILLA MATILDE CALLE 1 A-8 LOCAL #3
TOA ALTA PR
00953-2331
US

IV. Provider business mailing address

HC 46 BOX 6244
DORADO PR
00646-9635
US

V. Phone/Fax

Practice location:
  • Phone: 787-360-4933
  • Fax:
Mailing address:
  • Phone: 787-360-4933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. MAYRA S TORRES
Title or Position: PRESIDENTE
Credential: PSYD
Phone: 787-360-4933