Healthcare Provider Details
I. General information
NPI: 1013131432
Provider Name (Legal Business Name): NEONATOLOGIST ASSOCIATES, P.S.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/13/2007
Last Update Date: 09/18/2024
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
PR - 2 KM 173 TORRE SAN VICENTE DE PAUL SUITE 509-510
SAN GERMAN PR
00683
US
IV. Provider business mailing address
HC 03 BOX 26509
SAN GERMAN PR
00683
US
V. Phone/Fax
- Phone: 787-892-1920
- Fax: 787-264-2760
- Phone: 787-892-1920
- Fax: 787-264-2760
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
MIGUEL
A
SUAREZ VILLAMIL
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 787-892-1920