MEDICARE: TRUJILLO MEDICAL THERAPY GROUP

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	303	PR

General Provider Information

NPI Number	:	1912999376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUJILLO MEDICAL THERAPY GROUP

Provider Business Mailing Address
First Line	:	PO BOX 1892
Second Line	:
City	:	TRUJILLO ALTO
State	:	PR
Zip	:	00977-1892
Country	:	US
Telephone Number	:	787-283-2170
Fax Number	:	787-283-2170

Provider Business Practice Location Address
First Line	:	TRUJILLO ALTO PLZ
Second Line	:	TRUJILLO MEDICAL, SUITE 201
City	:	TRUJILLO ALTO
State	:	PR
Zip	:	00976-3600
Country	:	US
Telephone Number	:	787-283-2170
Fax Number	:	787-283-2170

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. NILMA E LUGO-MARCHANY
Credential	:	MPT,PT
Telephone Number	:	787-283-2170

Provider Enumeration Date	:	08/21/2005
Last Update Date	:	08/22/2020

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