Healthcare Provider Details

I. General information

NPI: 1194131102
Provider Name (Legal Business Name): CENTRO DE REHABILITACION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 07/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 CALLE MARGINAL URB LOIZA VALLEY
CANOVANAS PR
00729
US

IV. Provider business mailing address

43 CALLE MARGINAL URB LOIZA VALLEY
CANOVANAS PR
00729
US

V. Phone/Fax

Practice location:
  • Phone: 787-949-0811
  • Fax:
Mailing address:
  • Phone: 787-949-0811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EDUARDO A CHONG
Title or Position: PRESIDENT
Credential:
Phone: 787-949-0811