Healthcare Provider Details

I. General information

NPI: 1508426115
Provider Name (Legal Business Name): SENIOR PHYSICAL THERAPY OF PR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 06/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

B1 CALLE 6 MANSIONES DE GARDEN HILLS
GUAYNABO PR
00966
US

IV. Provider business mailing address

354 VIA SANTA CATALINA COND ALTOS REALES APT 914
GUAYNABO PR
00969
US

V. Phone/Fax

Practice location:
  • Phone: 787-810-3853
  • Fax: 787-993-6030
Mailing address:
  • Phone: 787-810-3853
  • Fax: 787-993-6030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: AYMEE PAGE
Title or Position: PRESIDENT
Credential: RPT
Phone: 787-810-3853