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General NPI Number Information
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NPI Number | 1083797534
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Entity Type | Organization
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Legal Business Name | NEUROCARE INC
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | TORRE MUSEO 312 OFIC 306
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City | SANTURCE
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State | PR
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Zip | 00909
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Country | US
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Telephone | 787-721-9163
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Fax |
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Provider Business Mailing Address
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Address Line | TORRE MUSEO 312 OFIC 306
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City | SANTURCE
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State | PR
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Zip | 00909
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Country | US
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Telephone | 787-721-9163
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOAQUIN MATOS
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Credential |
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Telephone | 787-721-9163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 113933
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License Number State | PR
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