| Fbc Mental Llc | |
|
Carr 21 S 3 # 11 Suite 304 Las Lomas San Juan PR 00921-0092 | |
| (787) 949-7050 | |
| Not Available |
| Full Name | Fbc Mental Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | Carr 21 S 3 # 11 Suite 304, San Juan, Puerto Rico |
| Authorized Official Name and Position | Frank Hernand Benitez Cruz (PRESIDENT) |
| Authorized Official Contact | 7879497050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fbc Mental Llc 3071 Ave Alejandrino Pmb 231 Guaynabo PR 00969 Ph: () - | Fbc Mental Llc Carr 21 S 3 # 11 Suite 304 Las Lomas San Juan PR 00921-0092 Ph: (787) 949-7050 |
| NPI Number | 1144840323 |
|---|---|
| Provider Enumeration Date | 04/17/2020 |
| Last Update Date | 04/17/2020 |
| Certification Date | 04/17/2020 |
| Medicare PECOS PAC ID | 5991117012 |
|---|---|
| Medicare Enrollment ID | O20201215001139 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144840323 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Frank H Benitez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336276658 PECOS PAC ID: 2365762804 Enrollment ID: I20150522001178 |
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