NPIMap

Organization Active NPI

Brain Base Therapy Center LLC

  • Hearing and Speech Clinic/Center
  • Coamo, PR
National Provider Identifier
1730714593
Registry record updated Nov 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X
Legal business name
BRAIN BASE THERAPY CENTER LLC
Practice address
Barrio Los Llanos
Carretera #14, KM 26.7
Coamo, PR 00769
Phone
(787) 202-5530
NPI assigned
Mar 11, 2020
Last updated
Nov 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2020

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

Authorized official

Name
Liza Robely Rodriguez, THL, CPETE, CNSLNPI 1073063194
Title
Presidenta
Phone
(787) 202-5530

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X
Early Intervention Provider Agency 252Y00000X
Clinic/Center 261Q00000X
Hearing and Speech Clinic/Center 261QH0700X Primary

Addresses

Primary practice location

Barrio Los Llanos
Carretera #14, KM 26.7
Coamo, PR 00769

Mailing address

Urb. Colinas de Verde Azul Calle Siena
# 46
Juana Diaz, PR 00795
Phone (787) 202-5530

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL brainbasedtherapycenter@gmail.com

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604707200000",
    "number": "1730714593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. COLINAS DE VERDE AZUL CALLE SIENA",
            "address_2": "# 46",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "00795",
            "telephone_number": "787-202-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BARRIO LOS LLANOS",
            "address_2": "CARRETERA #14, KM 26.7",
            "city": "COAMO",
            "state": "PR",
            "postal_code": "00769",
            "telephone_number": "787-202-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN BASE THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-11",
        "last_updated": "2020-11-07",
        "certification_date": "2020-11-07",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "LIZA",
        "authorized_official_middle_name": "ROBELY",
        "authorized_official_title_or_position": "PRESIDENTA",
        "authorized_official_telephone_number": "787-202-5530",
        "authorized_official_credential": "THL, CPETE, CNSL"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "brainbasedtherapycenter@gmail.com",
            "affiliation": "N",
            "address_1": "Barrio Los Llanos",
            "address_2": "carretera #14, Km 26.7",
            "city": "Coamo",
            "state": "PR",
            "country_code": "US",
            "postal_code": "00769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coamo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2020; 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.