Healthcare Provider Details

I. General information

NPI: 1942197504
Provider Name (Legal Business Name): NEUROEPILEPSY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CARR 165 CENTRO INTERNACIONAL DE MERCADEO SUITE 311
GUAYNABO PR
00968-8050
US

IV. Provider business mailing address

PO BOX 3190
VEGA ALTA PR
00692-3190
US

V. Phone/Fax

Practice location:
  • Phone: 787-224-9188
  • Fax:
Mailing address:
  • Phone: 787-396-3535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: JANICE M VARGAS RODRIGUEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 787-396-3535