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General NPI Number Information
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NPI Number | 1811959794
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Entity Type | Organization
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Legal Business Name | CENTRO NEUROLOGICO DEL NOROESTE, PSC
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 06/06/2014
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Provider Practice Location Address
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Address Line | CARR # 2 , KM 112.4 , BO. MORA 3121 CALLE MARGINAL
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City | ISABELA
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State | PR
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Zip | 00662
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Country | US
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Telephone | 787-872-8538
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Fax | 787-872-8538
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Provider Business Mailing Address
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Address Line | PMB 241 1312 AVENUE FELIX ALDARONDO
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City | ISABELA
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State | PR
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Zip | 00662
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Country | US
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Telephone | 787-872-8538
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Fax | 787-872-8538
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Authorized Official
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Title or Position | MD/NEUROLOGIST
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Name | AMARILIS CORCHADO
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Credential | MD
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Telephone | 787-872-8538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 13895
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License Number State | PR
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