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General NPI Number Information
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NPI Number | 1841105715
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Entity Type | Organization
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Legal Business Name | GENESIS NEUROLOGIA PEDIATRICA LLC
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Dates
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Enumeration Date | 08/17/2026
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Last Update Date | 08/17/2026
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Provider Practice Location Address
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Address Line | LOCAL #1 CARR. 21 #U3-1 URB LAS LOMAS
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City | SAN JUAN
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State | PR
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Zip | 00985
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Country | US
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Telephone | 787-396-0014
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Fax |
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Provider Business Mailing Address
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Address Line | L44 CALLE LIRIOS
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City | CAROLINA
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State | PR
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Zip | 00985-4225
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Country | US
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Telephone | 787-396-0014
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GENESIS N AYALA LOPEZ
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Credential | MD
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Telephone | 787-628-7504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number |
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License Number State |
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