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NPI Code Detail

MEDICARE: PHYSICS REHAB CENTER

MEDICARE: PHYSICS REHAB CENTER
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
1261QM1300XMulti-Specialty Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962054395
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICS REHAB CENTER
Provider Business Mailing Address
First Line : B38 CALLE NORTH VIEW COURT
Second Line : URB BALDWIN PARK
City : GUAYNABO
State : PR
Zip : 00969
Country : US
Telephone Number : 787-288-0808
Fax Number : 787-288-0888
Provider Business Practice Location Address
First Line : ID14 CALLE ALMACIGO
Second Line :
City : BAYAMON
State : PR
Zip : 00956-3104
Country : US
Telephone Number : 787-288-0808
Fax Number : 787-288-0888
Authorized Official
Title or Position : PRESIDENTE
Name : DR. OMAR GOMEZ MEDINA
Credential : MD
Telephone Number : 787-288-0808
Provider Enumeration Date : 07/16/2019
Last Update Date : 06/29/2020

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Directions to “PHYSICS REHAB CENTER ” Practice Location

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