Healthcare Provider Details

I. General information

NPI: 1194162867
Provider Name (Legal Business Name): CARIBBEAN NEUROLOGY CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2013
Last Update Date: 06/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 DOMENECH SUITE 407
SAN JUAN PR
00918
US

IV. Provider business mailing address

44 VILLA CAPARRA TOWER APT. 3-C
GUAYNABO PR
00966
US

V. Phone/Fax

Practice location:
  • Phone: 787-717-8188
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number18241
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number18241
License Number StatePR

VIII. Authorized Official

Name: CLAUDIA CAMUNAS
Title or Position: PRESIDENT
Credential:
Phone: 787-717-8188