Healthcare Provider Details
I. General information
NPI: 1699314187
Provider Name (Legal Business Name): COMPREHENSIVE THERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/31/2019
Last Update Date: 05/15/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
CARR # 2 KM 133.5 CENTERPLEX BUILDING SUITE # 201
AGUADA PR
00602
US
IV. Provider business mailing address
PO BOX 367457
SAN JUAN PR
00936-7457
US
V. Phone/Fax
- Phone: 787-594-1882
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0401X |
| Taxonomy | Comprehensive Outpatient Rehabilitation Facility (CORF) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JESUS
M
RAMOS
Title or Position: PRESIDENT
Credential: MD
Phone: 787-421-8063