Healthcare Provider Details

I. General information

NPI: 1881857092
Provider Name (Legal Business Name): DAVID JOEL CORTES VELEZ PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 07/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

13 CAMINO LOS BAEZ CONDOMINIO EL BOSQUE APT. 108
GUAYNABO PR
00971-9633
US

V. Phone/Fax

Practice location:
  • Phone: 787-787-8669
  • Fax:
Mailing address:
  • Phone: 787-649-7110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number1382
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: