| Prime Support Group | |
|
99 Calle Bloque 89 - 1 Urb. Villa Carolina Carolina PR 00985 | |
| (787) 360-1859 | |
| Not Available |
| Full Name | Prime Support Group |
|---|---|
| Speciality | Psychologist |
| Location | 99 Calle Bloque 89 - 1, Carolina, Puerto Rico |
| Authorized Official Name and Position | Steven Dalmau (PRESIDENT) |
| Authorized Official Contact | 7877692369 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Support Group 99 Calle Bloque 89 - 1 Urb. Villa Carolina Carolina PR 00985 Ph: (787) 769-2369 | Prime Support Group 99 Calle Bloque 89 - 1 Urb. Villa Carolina Carolina PR 00985 Ph: (787) 360-1859 |
| NPI Number | 1235593484 |
|---|---|
| Provider Enumeration Date | 04/13/2016 |
| Last Update Date | 09/28/2020 |
| Certification Date | 09/28/2020 |
| Medicare PECOS PAC ID | 9739464140 |
|---|---|
| Medicare Enrollment ID | O20170328000701 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235593484 | NPI | - | NPPES |
| Provider Name | Leslie A Colon Freyre |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568620102 PECOS PAC ID: 0648339135 Enrollment ID: I20110321000464 |
| Provider Name | Beatriz Ortiz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003035619 PECOS PAC ID: 5294982773 Enrollment ID: I20120906000422 |
| Provider Name | Maribel Rivera Cotto |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790050342 PECOS PAC ID: 1153606405 Enrollment ID: I20170328002831 |
| Provider Name | Rodnie Morant |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619102274 PECOS PAC ID: 1254606379 Enrollment ID: I20170928004000 |
| Provider Name | Yamilka M. Rolon Garcia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033268958 PECOS PAC ID: 8426147968 Enrollment ID: I20200821001239 |
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