| Innova Psychological Group, Llc | |
|
Carr 695 Km 2.0 Bo Higuillar Dorado PR 00646 | |
| (787) 315-6034 | |
| Not Available |
| Full Name | Innova Psychological Group, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | Carr 695 Km 2.0, Dorado, Puerto Rico |
| Authorized Official Name and Position | Juan A Gonzalez Rivera (ADMINISTRATOR) |
| Authorized Official Contact | 9395455241 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innova Psychological Group, Llc 500 Ave West Main Apt 215 Bayamon PR 00961-3875 Ph: (787) 315-6034 | Innova Psychological Group, Llc Carr 695 Km 2.0 Bo Higuillar Dorado PR 00646 Ph: (787) 315-6034 |
| NPI Number | 1861057580 |
|---|---|
| Provider Enumeration Date | 05/08/2019 |
| Last Update Date | 05/20/2021 |
| Certification Date | 05/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861057580 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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