Healthcare Provider Details

I. General information

NPI: 1992625487
Provider Name (Legal Business Name): NEO ESTHETIQUE EUROPEAN INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 AVE WINSTON CHURCHILL
SAN JUAN PR
00926-6728
US

IV. Provider business mailing address

138 AVE WINSTON CHURCHILL
SAN JUAN PR
00926-6013
US

V. Phone/Fax

Practice location:
  • Phone: 787-748-0020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BENIGNO GONZALEZ
Title or Position: MEMBER
Credential: MD
Phone: 787-398-5979