Healthcare Provider Details

I. General information

NPI: 1740322676
Provider Name (Legal Business Name): SALUD A TU ALCANCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 11/25/2021
Certification Date: 11/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO. QUEBRADA LARGA CARR 2 KM 141 HM 9
ANASCO PR
00610
US

IV. Provider business mailing address

PO BOX 2093
ANASCO PR
00610-3001
US

V. Phone/Fax

Practice location:
  • Phone: 787-826-4444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number1002
License Number StatePR

VIII. Authorized Official

Name: OSVALDO LOPERENA
Title or Position: SECRETARY, PHYSICAL THERAPIST
Credential:
Phone: 787-826-4444