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General NPI Number Information
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NPI Number | 1568352748
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Entity Type | Organization
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Legal Business Name | SPEKTRUM GROUP LLC
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | CARRETERA ESTATAL # 5 KM. 28.9 INTERIOR CAMINO LOS NEGRONES BO. GUADIANA
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City | NARANJITO
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State | PR
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Zip | 00719
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Country | US
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Telephone | 787-908-3122
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Fax |
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Provider Business Mailing Address
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Address Line | HC 71 BOX 3145
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City | NARANJITO
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State | PR
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Zip | 00719-9542
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Country | US
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Telephone | 787-908-3122
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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. IVANELYSSE ROSA NEGRON
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Credential | PHD
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Telephone | 787-908-3122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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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 | 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 #3
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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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 | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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