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General NPI Number Information
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NPI Number | 1609240274
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Entity Type | Organization
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Legal Business Name | EPILEPSIA NEUROIMAGENES, CSP
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 06/11/2020
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Provider Practice Location Address
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Address Line | CENTRO INTERNACIONAL DE MERCADEO CARR 165 TORRE 1 SUITE 311
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City | GUAYNABO
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State | PR
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Zip | 00968
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Country | US
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Telephone | 787-224-9188
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Fax | 939-437-4302
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Provider Business Mailing Address
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Address Line | 100 CARR 165 STE 311
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City | GUAYNABO
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State | PR
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Zip | 00968-8050
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Country | US
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Telephone | 787-224-9188
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Fax | 939-437-4302
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAVIER CHAPA DAVILA
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Credential | MD
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Telephone | 787-224-9188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 18212
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License Number State | PR
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