Healthcare Provider Details

I. General information

NPI: 1225394687
Provider Name (Legal Business Name): MRC PROPERTIES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2012
Last Update Date: 04/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

879 AVE MUNOZ RIVERA
SAN JUAN PR
00925-2107
US

IV. Provider business mailing address

PO BOX 800964
COTO LAUREL PR
00780-0964
US

V. Phone/Fax

Practice location:
  • Phone: 787-638-8295
  • Fax: 787-764-5962
Mailing address:
  • Phone: 787-638-8295
  • Fax: 787-764-5962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARITZA RIVERA
Title or Position: PRESIDENT
Credential: LIC
Phone: 787-638-8295