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General NPI Number Information
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NPI Number | 1124222682
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Entity Type | Organization
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Legal Business Name | NEOMED CENTER, INC
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 07/17/2024
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Provider Practice Location Address
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Address Line | 11 CALLE CONDADO
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City | SAN LORENZO
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State | PR
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Zip | 00754-4214
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Country | US
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Telephone | 787-737-2311
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Fax | 787-737-0244
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Provider Business Mailing Address
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Address Line | PO BOX 1277
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City | GURABO
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State | PR
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Zip | 00778-1277
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Country | US
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Telephone | 787-737-2311
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Fax | 787-737-0244
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Authorized Official
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Title or Position | CEO
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Name | DR. ROSA T CASTRO-AVILA
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Credential | M.D.
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Telephone | 787-737-2311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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