Provider Demographics
NPI:1245992239
Name:HEADACHE CENTER OF PR AND THE CARIBBEAN LLC
Entity type:Organization
Organization Name:HEADACHE CENTER OF PR AND THE CARIBBEAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-235-5969
Mailing Address - Street 1:PO BOX 3722
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-3722
Mailing Address - Country:US
Mailing Address - Phone:787-235-5969
Mailing Address - Fax:
Practice Address - Street 1:200 AVE WINSTON CHURCHILL # LOCAL104
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6651
Practice Address - Country:US
Practice Address - Phone:787-235-5969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty