Provider Demographics
NPI:1659824068
Name:PR NEURO CARDIOVASCULAR SERVICES LLC
Entity Type:Organization
Organization Name:PR NEURO CARDIOVASCULAR SERVICES LLC
Other - Org Name:PR NEURO CARDIOVASCULAR SERVICES LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
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:BOX 19191
Mailing Address - Street 2:AVE ROBERTO CEMENTE
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:ROBERTO CLEMENTE HSING
Practice Address - Street 2:33-4
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-7329
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:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Multi-Specialty