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General NPI Number Information
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NPI Number | 1053748418
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Entity Type | Organization
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Legal Business Name | CENTRO DE DIAGNOSTICO Y TRATAMIENTO DE ENFERMEDADES NEUROLOGICAS CSP
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Dates
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Enumeration Date | 10/01/2013
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Last Update Date | 03/10/2015
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Provider Practice Location Address
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Address Line | 420 AVE PONCE DE LEON SUITE 103
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City | SAN JUAN
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State | PR
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Zip | 00918-3416
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Country | US
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Telephone | 787-754-0145
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Fax | 787-764-3342
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Provider Business Mailing Address
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Address Line | 420 AVE PONCE DE LEON SUITE 103
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City | SAN JUAN
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State | PR
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Zip | 00918-3416
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Country | US
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Telephone | 787-754-0145
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Fax | 787-764-3342
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. HECTOR R. STELLA-ARRILLAGA
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Credential | M.D.
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Telephone | 787-754-0145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 3617
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License Number State | PR
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