MEDICARE: INTEGRAL HEALTHCARE SERVICES LLC

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	261QM1300X	Multi-Specialty Clinic/Center	4074	PR

General Provider Information

NPI Number	:	1548639206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRAL HEALTHCARE SERVICES LLC

Provider Business Mailing Address
First Line	:	RR 5 BOX 8760
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00956-9759
Country	:	US
Telephone Number	:	787-503-8889
Fax Number	:

Provider Business Practice Location Address
First Line	:	3180 CALLE CRESTA
Second Line	:	LEVITTOWN
City	:	TOA BAJA
State	:	PR
Zip	:	00949-3130
Country	:	US
Telephone Number	:	787-503-8889
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT OWNER
Name	:	DR. MELISSA BARRIOS
Credential	:	PSY.D
Telephone Number	:	787-503-8889

Provider Enumeration Date	:	09/23/2015
Last Update Date	:	09/23/2015

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