Provider Demographics
NPI:1306253729
Name:CENTRO DE EPILEPSIA Y NEUROLOGIA AVANZADA,PSC
Entity type:Organization
Organization Name:CENTRO DE EPILEPSIA Y NEUROLOGIA AVANZADA,PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIAS MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-203-1771
Mailing Address - Street 1:596 CALLE CESAR GONZALEZ APT 1124
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-4355
Mailing Address - Country:US
Mailing Address - Phone:787-751-2509
Mailing Address - Fax:
Practice Address - Street 1:101 AVE SAN PATRICIO
Practice Address - Street 2:MARAMAR PLAZA STE 1270
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-2645
Practice Address - Country:US
Practice Address - Phone:787-751-2509
Practice Address - Fax:787-781-5307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-17
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty
No2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsyGroup - Multi-Specialty