Healthcare Provider Details

I. General information

NPI: 1558967281
Provider Name (Legal Business Name): CLINICA TERAPEUTICA MADA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 814 KM 0.4 INT BO CEDRO ABAJO
NARANJITO PR
00719-9998
US

IV. Provider business mailing address

URB MONTECASINO HEIGHTS 467 CALLE RIO GRANDES
TOA ALTA PR
00953-3705
US

V. Phone/Fax

Practice location:
  • Phone: 787-462-1779
  • Fax:
Mailing address:
  • Phone: 787-462-1779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARYLEIN SERRANO ECHEVARRIA
Title or Position: OWNER
Credential:
Phone: 787-462-1779