Provider Demographics
NPI:1609240274
Name:EPILEPSIA NEUROIMAGENES, CSP
Entity Type:Organization
Organization Name:EPILEPSIA NEUROIMAGENES, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPA DAVILA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-224-9188
Mailing Address - Street 1:100 CARR 165 STE 311
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-8050
Mailing Address - Country:US
Mailing Address - Phone:787-224-9188
Mailing Address - Fax:939-437-4302
Practice Address - Street 1:CENTRO INTERNACIONAL DE MERCADEO CARR 165
Practice Address - Street 2:TORRE 1 SUITE 311
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968
Practice Address - Country:US
Practice Address - Phone:787-224-9188
Practice Address - Fax:939-437-4302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-19
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR182122084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty