1194162867 NPI number — CARIBBEAN NEUROLOGY CORP.

Table of content: (NPI 1194162867)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194162867 NPI number — CARIBBEAN NEUROLOGY CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARIBBEAN NEUROLOGY CORP.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194162867
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/04/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
44 VILLA CAPARRA TOWER APT. 3-C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00966
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 DOMENECH SUITE 407
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-717-8188
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/04/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CAMUNAS
Authorized Official First Name:
CLAUDIA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-717-8188

Provider Taxonomy Codes

  • Taxonomy code: 2084N0008X , with the licence number:  18241 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0400X , with the licence number: 18241 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)