MEDICARE: BAY VIEW BEHAVIORAL CENTER CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)		PR

General Provider Information

NPI Number	:	1255644563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY VIEW BEHAVIORAL CENTER CORP

Provider Business Mailing Address
First Line	:	D 54 ZAFIRO
Second Line	:	PASEO REAL
City	:	DORADO
State	:	PR
Zip	:	00646
Country	:	US
Telephone Number	:	787-404-1668
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 CALLE PRINCIPAL
Second Line	:	BAY VIEW
City	:	CATANO
State	:	PR
Zip	:	00962-4269
Country	:	US
Telephone Number	:	787-200-0860
Fax Number	:

Authorized Official
Title or Position	:	PSYQUIATRIST
Name	:	DR. JOSE ROY VAZQUEZ-MALDONADO
Credential	:	M.D.
Telephone Number	:	787-200-0860

Provider Enumeration Date	:	07/16/2010
Last Update Date	:	07/16/2010

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