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General NPI Number Information
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NPI Number | 1487354841
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Entity Type | Organization
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Legal Business Name | PUERTO RICO MULTIPLE SCLEROSIS CENTER LLC
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Dates
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Enumeration Date | 03/06/2023
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 500 AVE DEGETAU HIMA PLAZA 1 SUITE 308 PISO 3
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City | CAGUAS
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State | PR
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Zip | 00725-7303
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Country | US
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Telephone | 787-474-7678
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Fax | 787-474-7680
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Provider Business Mailing Address
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Address Line | 500 AVE DEGETAU HIMA PLAZA I SUITE 308 PISO 3
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City | CAGUAS
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State | PR
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Zip | 00725-7303
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Country | US
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Telephone | 787-474-7678
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Fax | 787-474-7680
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSE AVILA ORNELAS
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Credential | MD
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Telephone | 787-474-7678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy 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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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