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General NPI Number Information
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NPI Number | 1194491878
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Entity Type | Organization
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Legal Business Name | NRV NEUROPEDS LLC
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Dates
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Enumeration Date | 08/21/2021
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 715 AVE PONCE DE LEON PARADA 37.5 CLINICAS SUB ESPECIALISTA PEDIATRICAS PISO 1
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City | SAN JUAN
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State | PR
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Zip | 00917-5432
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Country | US
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Telephone | 787-758-2000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 353
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City | SAN LORENZO
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State | PR
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Zip | 00754-0353
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Country | US
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Telephone | 787-209-0050
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NATALIA L RODRIGUEZ VAZQUEZ
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Credential | MD
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Telephone | 787-758-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty 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 | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number |
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License Number State |
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