Provider Demographics
NPI:1760677728
Name:CENTRO NEYMAR
Entity Type:Organization
Organization Name:CENTRO NEYMAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NEYSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORRACA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-780-2890
Mailing Address - Street 1:PO BOX 504
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-0504
Mailing Address - Country:US
Mailing Address - Phone:787-780-2890
Mailing Address - Fax:787-785-4809
Practice Address - Street 1:I7 AVE BETANCES
Practice Address - Street 2:HERAMANAS DAVILA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5109
Practice Address - Country:US
Practice Address - Phone:787-780-2890
Practice Address - Fax:787-785-4809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR366231H00000X
PR219235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty