Healthcare Provider Details

I. General information

NPI: 1437425030
Provider Name (Legal Business Name): LAS AMERICAS PAIN INTERVENTIONAL CENTER PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2012
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LA TORRE DE PLAZA LAS AMERICAS SUITE 617 525 AVE ROOSEVELT
HATO REY PR
00918
US

IV. Provider business mailing address

CROSANDRA A 27 PARQUE DE BUCARE
GUAYNABO PR
00969
US

V. Phone/Fax

Practice location:
  • Phone: 787-200-7550
  • Fax: 787-200-7553
Mailing address:
  • Phone: 787-200-7550
  • Fax: 787-200-7553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number14071
License Number StatePR

VIII. Authorized Official

Name: AUREA TERESA NEGRON
Title or Position: PRESIDENT AND OWNER
Credential: M.D., FIPP
Phone: 787-200-7550