Healthcare Provider Details

I. General information

NPI: 1982976536
Provider Name (Legal Business Name): PHYSIOTHERAPY REHABILITATION SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2012
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB SANTA JUANITA UU43 CALLE 30
BAYAMON PR
00956-4701
US

IV. Provider business mailing address

PO BOX 444
BAYAMON PR
00960-0444
US

V. Phone/Fax

Practice location:
  • Phone: 787-787-8669
  • Fax: 787-786-7865
Mailing address:
  • Phone: 787-787-8669
  • Fax: 787-786-7865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number406504
License Number StatePR

VIII. Authorized Official

Name: DR. GUSTAVO J MOREY CRUZ
Title or Position: PRESIDENT
Credential: DPT
Phone: 787-787-8669