Pediatric Neuromuscular LLC

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

Legal business name

PEDIATRIC NEUROMUSCULAR LLC

Practice address

252 Calle San Jorge
Edif Medico San Jorge Suite 307
San Juan, PR 00912

Phone

(787) 233-5933

NPI assigned

Jul 28, 2021

Last updated

Sep 28, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Alexandra M Montalvo Acevedo, MDNPI 1174938195

Title

President

Phone

(787) 233-5933

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alexandra M Montalvo Acevedo, MD

  • Neuromuscular Medicine (Psychiatry & Neurology) Physician
  • San Juan, PR
  • NPI 1174938195
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1295408029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 VIOLETA",
            "address_2": "URB SAN FRANCISCO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009276211",
            "telephone_number": "787-233-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 CALLE SAN JORGE",
            "address_2": "EDIF MEDICO SAN JORGE SUITE 307",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00912",
            "telephone_number": "787-233-5933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC NEUROMUSCULAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "MONTALVO ACEVEDO",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-233-5933",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Management Services
• Pediatrix Medical Group
• Rene Arturo Pedraza Espada
• Grisel Marie Pedraza-Rosa, M.D.

• Neurology with Special Qualifications in Child Neurology Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.