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General NPI Number Information
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NPI Number | 1780556068
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Entity Type | Organization
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Legal Business Name | PLENAMENTE GROUP LLC
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 360 CALLE ENSENADA
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City | SAN JUAN
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State | PR
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Zip | 00920-3504
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Country | US
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Telephone | 787-920-6051
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Fax |
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Provider Business Mailing Address
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Address Line | 188 VISTA DEL MAR PANORAMA VILLAGE
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City | BAYAMON
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State | PR
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Zip | 00957-4407
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Country | US
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Telephone | 787-454-3876
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | MELISSA SOTO
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Credential | PHD
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Telephone | 787-454-3876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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