Provider Demographics
NPI:1275573958
Name:PROMO SALUD INC
Entity Type:Organization
Organization Name:PROMO SALUD INC
Other - Org Name:PUERTO RICO NEURO CARDIOVASCULAR SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EJECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:MELENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-750-2697
Mailing Address - Street 1:AVE FERNANDEZ JUNCOS
Mailing Address - Street 2:BOX 19191
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910-9191
Mailing Address - Country:US
Mailing Address - Phone:787-750-2697
Mailing Address - Fax:787-750-2697
Practice Address - Street 1:AVE CLEMENTE 23-4
Practice Address - Street 2:VILLA CAROLINA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-750-2697
Practice Address - Fax:787-750-2697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0088709Medicare PIN