Healthcare Provider Details

I. General information

NPI: 1083980197
Provider Name (Legal Business Name): S & M PHYSICAL REHABILITATION PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2012
Last Update Date: 06/05/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MARINA PLAZA OFICINA 22-23 CARR. 189
GURABO PR
00778
US

IV. Provider business mailing address

CIUDAD JARDIN 22 MANZANILLA
GURABO PR
00778-9647
US

V. Phone/Fax

Practice location:
  • Phone: 787-737-0781
  • Fax: 787-712-0979
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MAYDEL MONTANEZ OCASIO
Title or Position: PRESIDENT
Credential:
Phone: 787-737-0781