Healthcare Provider Details

I. General information

NPI: 1598656449
Provider Name (Legal Business Name): NEURO MOVIMIENTO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 07/10/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE HERNANDEZ CARRION #668 URB. ATHENAS, TORRE MEDICA S611, MANATI MEDICAL CENTER
MANATI PR
00674
US

IV. Provider business mailing address

PO BOX 190151
SAN JUAN PR
00919-0151
US

V. Phone/Fax

Practice location:
  • Phone: 787-621-3755
  • Fax:
Mailing address:
  • Phone: 787-621-3755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: LAURA SURILLO-DAHDAH
Title or Position: PRESIDENT
Credential: MD
Phone: 787-951-7325