Sociedad de Salud Mental, LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

SOCIEDAD DE SALUD MENTAL, LLC

Practice address

118 Carr 159 Ste 2B
Ortiz Medical Plaza
Corozal, PR 00783-2346

Phone

(787) 859-4973

Fax

(787) 859-5152

NPI assigned

Oct 1, 2014

Last updated

Oct 1, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Hipolito B Costa-Perez, M.D.

Title

Ceo

Phone

(787) 467-1007

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412121600000",
    "number": "1831592120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367631",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009367631",
            "telephone_number": "787-859-4973",
            "fax_number": "787-859-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 CARR 159 STE 2B",
            "address_2": "ORTIZ MEDICAL PLAZA",
            "city": "COROZAL",
            "state": "PR",
            "postal_code": "007832346",
            "telephone_number": "787-859-4973",
            "fax_number": "787-859-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCIEDAD DE SALUD MENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-01",
        "status": "A",
        "authorized_official_last_name": "COSTA-PEREZ",
        "authorized_official_first_name": "HIPOLITO",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "787-467-1007",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Corozal, PR
• Providers in Corozal, PR by specialty
• Exclusive Provider Organization in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; 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.