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General NPI Number Information
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NPI Number | 1235959966
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Entity Type | Organization
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Legal Business Name | CERVONI MD LLC
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Dates
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Enumeration Date | 10/16/2024
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 5-106 CALLE SANTA CRUZ SANTA ROSA
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City | BAYAMON
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State | PR
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Zip | 00959
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Country | US
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Telephone | 939-397-6278
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Fax |
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Provider Business Mailing Address
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Address Line | URB EL DORADO #C3 CALLE B
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 939-397-6278
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN MANUEL CERVONI ROSARIO
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Credential | MD
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Telephone | 939-397-6278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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