Healthcare Provider Details

I. General information

NPI: 1194757435
Provider Name (Legal Business Name): CARDIO NEURO MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE BORINGUEN 2004 BARRCO OBRERO
SANTURCE PR
00916
US

IV. Provider business mailing address

PO BOX 14511 BARRCO OBRERO
SANTURCE PR
00916
US

V. Phone/Fax

Practice location:
  • Phone: 787-268-0528
  • Fax: 787-268-0525
Mailing address:
  • Phone: 787-268-0525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246X00000X
TaxonomyCardiovascular Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2472E0500X
TaxonomyEEG Technician
License Number
License Number State

VIII. Authorized Official

Name: NEIRA LUGO
Title or Position: ADMINISTRATOR
Credential:
Phone: 787-268-0525