Provider Demographics
NPI:1881823607
Name:CLINICA DE NEUROLOGIA Y MEDICINA NEUROMUSCULAR, INC.
Entity Type:Organization
Organization Name:CLINICA DE NEUROLOGIA Y MEDICINA NEUROMUSCULAR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIUD
Authorized Official - Middle Name:
Authorized Official - Last Name:IRIZARRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-310-7685
Mailing Address - Street 1:36 CALLE NEVAREZ
Mailing Address - Street 2:CONDOMINIO LOS OLMOS, APT. 8A
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-4500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AVE JESUS T PINERO # 282
Practice Address - Street 2:EDIFICIO PLAZA EL AMAL #210
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-4003
Practice Address - Country:US
Practice Address - Phone:787-310-7685
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR016446261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty