Centro de Servicios Neurologicos de Mayaguez, CSP

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

License

13818 Issued in PR

Legal business name

CENTRO DE SERVICIOS NEUROLOGICOS DE MAYAGUEZ, CSP

Practice address

351 Ave Hostos Ste 309
Mayaguez, PR 00680-1504

Phone

(787) 805-7319

Fax

(787) 805-0577

NPI assigned

Apr 26, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Merbil R Gonzalez-Diaz, M.D.NPI 1902878614

Title

President

Phone

(787) 805-7319

Specialties & licenses 1

Addresses

Other names 1

• CENTRO NEUROLOGICO DEL OESTE Doing business as

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Merbil Gonzalez Diaz, M.D.

  • Neurology Physician
  • Mayaguez, PR
  • NPI 1902878614
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303776000000",
    "number": "1780975607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 AVE HOSTOS STE 309",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006801504",
            "telephone_number": "787-805-7319",
            "fax_number": "787-805-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 AVE HOSTOS STE 309",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006801504",
            "telephone_number": "787-805-7319",
            "fax_number": "787-805-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO DE SERVICIOS NEUROLOGICOS DE MAYAGUEZ, CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-26",
        "last_updated": "2011-04-26",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ-DIAZ",
        "authorized_official_first_name": "MERBIL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-805-7319",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "PR",
            "license": "13818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTRO NEUROLOGICO DEL OESTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Neurophysiology Physician in Mayaguez, PR
• Providers in Mayaguez, PR by specialty
• Clinical Neurophysiology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.