Provider Demographics
NPI:1447791322
Name:NEUROSPINAL HEALTH CENTER
Entity Type:Organization
Organization Name:NEUROSPINAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC NEUROLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:VILMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTO GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DACNB
Authorized Official - Phone:787-564-4736
Mailing Address - Street 1:381 AVE FELISA RINCON
Mailing Address - Street 2:COND PASEOMONTE APT. 1104
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-564-4736
Mailing Address - Fax:
Practice Address - Street 1:1400 AVE DE DIEGO
Practice Address - Street 2:ST.130 PARQUE ESCORIAL
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-4701
Practice Address - Country:US
Practice Address - Phone:787-564-4736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0631261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center