NPIMap

Organization Active NPI

Centro Individual de Medicina Especializada LLC

  • Psychiatry Physician
  • Guaynabo, PR
National Provider Identifier
1629966007
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
CENTRO INDIVIDUAL DE MEDICINA ESPECIALIZADA LLC
Practice address
140 Ave Las Cumbres
Guaynabo, PR 00969-5523
Phone
(787) 731-5785
NPI assigned
Jun 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Ailed Rivera Soto
Title
Administrator
Phone
(787) 354-2514

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Physical Therapy Clinic/Center 261QP2000X
Rehabilitation Clinic/Center 261QR0400X

Addresses

Primary practice location

140 Ave Las Cumbres
Guaynabo, PR 00969-5523

Mailing address

PO Box 1475
Carolina, PR 00984-1475
Phone (787) 354-2514

Other identifiers 1

IdentifierTypeStateIssuer
10166MedicaidPR

Other names 1

  • CIME Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750809600000",
    "number": "1629966007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009841475",
            "telephone_number": "787-354-2514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 AVE LAS CUMBRES",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009695523",
            "telephone_number": "787-731-5785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO INDIVIDUAL DE MEDICINA ESPECIALIZADA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A",
        "authorized_official_last_name": "SOTO",
        "authorized_official_first_name": "AILED",
        "authorized_official_middle_name": "RIVERA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-354-2514",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10166",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CIME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Guaynabo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.