Provider Demographics
NPI:1316917438
Name:CENTRO ESPECIALIZADO EN DOLOR DE CABEZAY NEUROLOGIA, CSP
Entity type:Organization
Organization Name:CENTRO ESPECIALIZADO EN DOLOR DE CABEZAY NEUROLOGIA, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:S
Authorized Official - Last Name:MIRANDA-DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-767-5944
Mailing Address - Street 1:COND. PLAYA SERENA
Mailing Address - Street 2:7061 CARR 187 SUITE 401
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979
Mailing Address - Country:US
Mailing Address - Phone:787-767-5944
Mailing Address - Fax:787-765-5786
Practice Address - Street 1:SAN FRANCISCO TOWER
Practice Address - Street 2:365 DE DIEGO AVE SUITE 401
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-767-5944
Practice Address - Fax:787-765-5786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR99122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E63380Medicare UPIN
83816Medicare ID - Type Unspecified