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General NPI Number Information
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NPI Number | 1801652821
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Entity Type | Organization
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Legal Business Name | NEUROCARE PSYCHOLOGY SERVICES LLC
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Dates
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Enumeration Date | 02/27/2024
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | CENTRO INTERNATIONAL DE MERCADEO 90 CARR 165 TORRE 2 SUITE 302
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City | GUAYNABO
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State | PR
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Zip | 00968-8063
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Country | US
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Telephone | 939-905-6420
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Fax |
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Provider Business Mailing Address
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Address Line | HC 2 BOX 21265
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City | SAN SEBASTIAN
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State | PR
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Zip | 00685-9219
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Country | US
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Telephone | 787-996-3920
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JUAN M SALAS VAZQUEZ
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Credential | PSYD
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Telephone | 939-905-6420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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