Servicios Psicologicos Renuevate LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

SERVICIOS PSICOLOGICOS RENUEVATE LLC

Practice address

Carr. 198 KM 22.0
Bo. Montones I
Las Piedras, PR 00771-0198

Phone

(787) 716-0050

NPI assigned

Nov 5, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Bernardo RoqueNPI 1295991578

Title

Psy.D.

Phone

(787) 645-2587

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bernardo Roque, PSY.D, HCT

  • Clinical Psychologist
  • Las Piedras, PR
  • NPI 1295991578
  Medicare reassignment NPD Authorized official
• Julie M Olivencia Sanabria, MD

  • Child & Adolescent Psychiatry Physician
  • Fajardo, PR
  • NPI 1053355784
  NPD (past)

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1891518189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. ALTURAS DE SAN BENITO",
            "address_2": "CALLE REINA DE LA PAZ 11",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007919202",
            "telephone_number": "787-645-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 198 KM 22.0",
            "address_2": "BO. MONTONES I",
            "city": "LAS PIEDRAS",
            "state": "PR",
            "postal_code": "007710198",
            "telephone_number": "787-716-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERVICIOS PSICOLOGICOS RENUEVATE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-02",
        "status": "A",
        "authorized_official_last_name": "ROQUE",
        "authorized_official_first_name": "BERNARDO",
        "authorized_official_title_or_position": "PSY.D.",
        "authorized_official_telephone_number": "787-645-2587",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omayra Santory Ortiz, M.D.
• Julio Santory-Pena, M.D.
• Damaris Sepulveda Diaz
• Ronald Serrano Ramos, MD
• Jason Serrano
• Sica Medical LLC
• Adleen Yelissa Silva Alicea, THL/TO
• Carmen Silva Serrano, 11266 M.D
• Marilyn Soto Escribano, PSYCOLOGIST
• Luz Katherine Soto Rivera

• Clinical Psychologist in Las Piedras, PR
• Providers in Las Piedras, PR by specialty
• Clinical Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.