Healthcare Provider Details

I. General information

NPI: 1578709440
Provider Name (Legal Business Name): LUIS CARLOS NATALI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2008
Last Update Date: 05/27/2022
Certification Date: 05/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 NORTE CALLE RAMON E. BETANCES
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

1702 CALLE JOSE ABAD BONILLA
MAYAGUEZ PR
00682-7915
US

V. Phone/Fax

Practice location:
  • Phone: 787-831-4215
  • Fax: 787-827-8161
Mailing address:
  • Phone: 191-439-3996
  • Fax: 310-469-4603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberA115959
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA115959
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA115959
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number017912
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: