=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073493474
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CREATELOS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/05/2025
-----------------------------------------------------
Last Update Date | 09/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 148 CALLE CARRAZO LOCAL #300
-----------------------------------------------------
City | GUAYNABO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00969
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 939-652-5546
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 120 TURABO CLUSTERS
-----------------------------------------------------
City | CAGUAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00727-2546
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 939-266-3400
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | CELIA A. CASTANER
-----------------------------------------------------
Credential | DR
-----------------------------------------------------
Telephone | 939-266-3400
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TS0200X
-----------------------------------------------------
Taxonomy Name | School Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------