Healthcare Provider Details

I. General information

NPI: 1982681565
Provider Name (Legal Business Name): SERVICIOS INTEGRADOS DE REHABILITACION DEL OESTE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STREET 4 HOUSE L-10 COLINAS DEL OESTE
HORMIGUEROS PR
00660
US

IV. Provider business mailing address

PO BOX 1302
HORMIGUEROS PR
00660-5302
US

V. Phone/Fax

Practice location:
  • Phone: 787-849-2179
  • Fax: 787-849-2205
Mailing address:
  • Phone: 787-849-2179
  • Fax: 787-849-2205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number6
License Number StatePR

VIII. Authorized Official

Name: DAISY MARTINEZ
Title or Position: CORPORATE DIRECTOR
Credential:
Phone: 787-849-2179