Healthcare Provider Details

I. General information

NPI: 1700681004
Provider Name (Legal Business Name): AS NEUROLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2025
Last Update Date: 03/10/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 AVE PONCE DE LEON PARADA 37.5 HOSP AUXILIO MUTUO CLINICAS SUBESPECIALISTAS PEDIATRICA
SAN JUAN PR
00917-5032
US

IV. Provider business mailing address

15 AVE MUNOZ RIVERA STE 100-B PMB 120
SAN JUAN PR
00901-2480
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2000
  • Fax:
Mailing address:
  • Phone: 787-758-2000
  • Fax: 787-648-8635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDRA R SANTANA ALMANSA
Title or Position: PRESIDENT
Credential: MD
Phone: 787-758-2000