Healthcare Provider Details

I. General information

NPI: 1649499294
Provider Name (Legal Business Name): CENTRO DE REHABILITACION Y MEDICINA DEL DEPORTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARIMED PLAZA B1 CALLE SANTA CRUZ STE. 406
BAYAMON PR
00961-6933
US

IV. Provider business mailing address

CARIMED PLAZA B1 CALLE SANTA CRUZ STE. 406
BAYAMON PR
00961-6933
US

V. Phone/Fax

Practice location:
  • Phone: 787-740-2270
  • Fax: 787-785-7277
Mailing address:
  • Phone: 787-779-6896
  • Fax: 787-785-7277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081N0008X
TaxonomyNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSE E ARIAS BENABE
Title or Position: GEN PTR
Credential: M.D.
Phone: 787-779-6896