Healthcare Provider Details

I. General information

NPI: 1306759022
Provider Name (Legal Business Name): SICOH CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO SUSUA BAJA CARR 368 KM 12.7
YAUCO PR
00698-2501
US

IV. Provider business mailing address

PO BOX 5201
YAUCO PR
00698-5201
US

V. Phone/Fax

Practice location:
  • Phone: 787-515-7426
  • Fax:
Mailing address:
  • Phone: 787-515-7426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. CARMEN MINERVA QUINONES
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 787-473-4712