MEDICARE: ITURREGUI REHAB CENTER CSP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center	730	NY

General Provider Information

NPI Number	:	1174895726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ITURREGUI REHAB CENTER CSP

Provider Business Mailing Address
First Line	:	PO BOX 2809
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00960-2809
Country	:	US
Telephone Number	:	787-757-2146
Fax Number	:	787-757-2146

Provider Business Practice Location Address
First Line	:	SANTURCE MEDICAL MALL
Second Line	:	AVE PONCE DE LEON 1801 SUITE 312
City	:	SAN JUAN
State	:	PR
Zip	:	00909-0000
Country	:	US
Telephone Number	:	787-757-2146
Fax Number	:	787-757-2146

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. MILAGROS OTERO
Credential	:	P.T.
Telephone Number	:	787-757-2146

Provider Enumeration Date	:	01/29/2012
Last Update Date	:	02/11/2014

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