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General NPI Number Information
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NPI Number | 1316917438
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Entity Type | Organization
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Legal Business Name | CENTRO ESPECIALIZADO EN DOLOR DE CABEZAY NEUROLOGIA, CSP
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | SAN FRANCISCO TOWER 365 DE DIEGO AVE SUITE 401
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City | SAN JUAN
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State | PR
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Zip | 00909
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Country | US
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Telephone | 787-767-5944
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Fax | 787-765-5786
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Provider Business Mailing Address
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Address Line | COND. PLAYA SERENA 7061 CARR 187 SUITE 401
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City | CAROLINA
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State | PR
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Zip | 00979
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Country | US
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Telephone | 787-767-5944
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Fax | 787-765-5786
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HECTOR S MIRANDA-DELGADO
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Credential | MD
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Telephone | 787-767-5944
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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 | 9912
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License Number State | PR
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