# WESTERN PR NEUROLOGICAL CLINIC CSP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265869168
- **Authorized official:** JOSE ALBERTO ACEVEDO M.D. (CEO)
- **Authorized official phone:** (787) 447-8819

## Contact information

- **Practice address:** MEDICAL EMPORIUM II CARR \#2, NOSTOS AVENUE KY. 157, SUITE 3A, MAYAGUEZ, PR 00680
- **Practice address phone:** (787) 265-6622
- **Practice address fax:** (787) 265-6622
- **Mailing address:** \#42 COSTA BRAVA STREET, URB. LAS VISTAS, CABO ROJO, PR 00623
- **Mailing address phone:** (787) 265-6622
- **Mailing address fax:** (787) 265-6622

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 16784 | PR | Yes |

## Other

- **Enumeration date:** 10/09/2013
- **Last updated:** 10/09/2013