MEDICARE: GRUPO DE BIENESTAR Y DESARROLLO INTEGRAL LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	235Z00000X	Speech-Language Pathologist
2	225100000X	Physical Therapist
3	103TS0200X	School Psychologist
4	103TC1900X	Counseling Psychologist
5	224Z00000X	Occupational Therapy Assistant
6	225X00000X	Occupational Therapist
7	103TF0000X	Family Psychologist
8	103TB0200X	Cognitive & Behavioral Psychologist
9	2355S0801X	Speech-Language Assistant
10	225XM0800X	Mental Health Occupational Therapist
11	225XP0200X	Pediatric Occupational Therapist
12	103TC2200X	Clinical Child & Adolescent Psychologist
13	103T00000X	Psychologist

General Provider Information

NPI Number	:	1366384265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRUPO DE BIENESTAR Y DESARROLLO INTEGRAL LLC

Provider Business Mailing Address
First Line	:	PO BOX 2537
Second Line	:
City	:	ISABELA
State	:	PR
Zip	:	00662-9537
Country	:	US
Telephone Number	:	939-717-1653
Fax Number	:

Provider Business Practice Location Address
First Line	:	CARR. 115 KM. 23.7
Second Line	:	BO. ASOMANTE
City	:	AGUADA
State	:	PR
Zip	:	00602
Country	:	US
Telephone Number	:	787-458-4149
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	OMAR A SAMOT CRUZ
Credential	:
Telephone Number	:	939-717-1653

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	05/04/2026

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