Provider Demographics
NPI:1972392066
Name:CENTRO TERAPEUTICO INNOVATE INC
Entity type:Organization
Organization Name:CENTRO TERAPEUTICO INNOVATE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENTE AUTORIZADO
Authorized Official - Prefix:
Authorized Official - First Name:KEYSHLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:FLORES PABON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-432-1348
Mailing Address - Street 1:URB. ESTANCIAS DE JUANA DIAZ CALLE ALMENDRO 205
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795
Mailing Address - Country:US
Mailing Address - Phone:787-432-1348
Mailing Address - Fax:
Practice Address - Street 1:BO. LLANOS DEL SUR CALLE ESMERALDA ESQ LAS ROSAS COTO L
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00780
Practice Address - Country:US
Practice Address - Phone:787-284-4991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation