1992654891 NPI number — NEUROGENESIS CENTRO DE TRATAMIENTO MULTIDISCIPLINARIO, LLC

Table of content: (NPI 1992654891)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992654891 NPI number — NEUROGENESIS CENTRO DE TRATAMIENTO MULTIDISCIPLINARIO, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEUROGENESIS CENTRO DE TRATAMIENTO MULTIDISCIPLINARIO, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
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NPI Number Information

NPI Number:
1992654891
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/23/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB ESTANCIAS DEL MAYORAL
Provider Second Line Business Mailing Address:
CALLE GUAJANA 12012
Provider Business Mailing Address City Name:
VILLALBA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00766-2430
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
939-630-0860
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
M 133 METRO PLAZA LAS MONJITAS
Provider Second Line Business Practice Location Address:
AVE TITO CASTRO 1255 PASEOS LAS MONJITAS
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
939-630-0860
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/23/2026

Additional Information

Authorized Official

Authorized Official Last Name:
SOTO HERNANDEZ
Authorized Official First Name:
ELVIN
Authorized Official Middle Name:
Authorized Official Title or Position:
CLINICAL PSYCHOLOGIST
Authorized Official Telephone Number:
939-630-0860

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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