Healthcare Provider Details

I. General information

NPI: 1609907153
Provider Name (Legal Business Name): CENTRO DE REHABILITACION Y TERAPIA FISICA EL-RAPHA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 02/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 474
ISABELA PR
00662
US

IV. Provider business mailing address

PO BOX 1731
ISABELA PR
00662-1731
US

V. Phone/Fax

Practice location:
  • Phone: 787-872-1628
  • Fax: 787-872-1628
Mailing address:
  • Phone: 787-872-1628
  • Fax: 787-872-1628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: PEDRO PINERO
Title or Position: PRESIDENT
Credential: RPT
Phone: 787-221-3307