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General NPI Number Information
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NPI Number | 1164816583
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Entity Type | Organization
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Legal Business Name | MEDICAL PSYCHIATRIC SERVICES PSC
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 1396 CALLE SAN RAFAEL MEDICAL PAVILLION SUITE 4
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City | SAN JAUN
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State | PR
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Zip | 00909
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Country | US
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Telephone | 787-725-2910
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Fax |
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Provider Business Mailing Address
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Address Line | 1396 CALLE SAN RAFAEL MEDICAL PAVILLION SUITE 4
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City | SAN JAUN
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State | PR
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Zip | 00909
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Country | US
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Telephone | 787-725-2910
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JUAN JOSE RODRIGUEZ VELEZ
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Credential | M.D.
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Telephone | 787-562-5414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 08550
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License Number State | PR
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