Healthcare Provider Details

I. General information

NPI: 1194775338
Provider Name (Legal Business Name): CLINICA DE TERAPIA FISICA Y REHABILITACION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 CALLE BALDORIOTY
NAGUABO PR
00718-2222
US

IV. Provider business mailing address

PO BOX 70
NAGUABO PR
00718-0070
US

V. Phone/Fax

Practice location:
  • Phone: 787-874-1449
  • Fax: 787-874-1449
Mailing address:
  • Phone: 787-874-1449
  • Fax: 787-874-1449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number3310
License Number StatePR

VIII. Authorized Official

Name: MARIA M SANCHEZ
Title or Position: PRESIDENT
Credential: PT
Phone: 787-874-1449