| Prospective Psychiatry Group, Psc | |
|
Western Industrial Park Rochelaise Center, Suite 303 Mayaguez PR 00680-0000 | |
| (787) 404-9798 | |
| Not Available |
| Full Name | Prospective Psychiatry Group, Psc |
|---|---|
| Speciality | Exclusive Provider Organization |
| Location | Western Industrial Park, Mayaguez, Puerto Rico |
| Authorized Official Name and Position | Erik G Medina (PRESIDENT) |
| Authorized Official Contact | 7876468149 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prospective Psychiatry Group, Psc Urb. Mansiones 3125 Pedregales Cabo Rojo PR 00623-8978 Ph: () - | Prospective Psychiatry Group, Psc Western Industrial Park Rochelaise Center, Suite 303 Mayaguez PR 00680-0000 Ph: (787) 404-9798 |
| NPI Number | 1023386026 |
|---|---|
| Provider Enumeration Date | 12/05/2011 |
| Last Update Date | 12/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023386026 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 17743 (Puerto Rico) | Secondary |
| 302F00000X | Exclusive Provider Organization | 17743 (Puerto Rico) | Primary |
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