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General NPI Number Information
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NPI Number | 1154961613
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Entity Type | Organization
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Legal Business Name | CENTRALIS MED LLC
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | URB CONDADO VIEJO H17 CALLE JOSE VILLARES
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City | CAGUAS
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State | PR
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Zip | 00725-2463
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Country | US
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Telephone | 787-510-6187
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Fax | 787-848-1588
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Provider Business Mailing Address
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Address Line | URB CONDADO VIEJO H17 CALLE JOSE VILLARES
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City | CAGUAS
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State | PR
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Zip | 00725-2463
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Country | US
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Telephone | 787-510-6187
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Fax | 787-848-1588
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANGEL MARTINEZ
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Credential | MD
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Telephone | 787-510-6187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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